Self-expanding metallic stents for acute obstruction of the proximal colorectal cancer

Abstract

Objective To evaluate the efficacy of self-expanding metallic stents（SEMS）for acute proximal colon obstruction due to colon carcinoma.Methods From September 2004 to June 2010, a total of 81 patients（47 males and 34 females, aged 18-94 yr, mean 66.2 ± 7.5 yr）with acute proximal colon obstruction（proximal to spleen flex）caused by colon carcinoma were treated by SEMS.The success rate of stent drainage, safety of the procedure and the surgical removal rate of the carcinoma were evaluated.Results The tumors were located in transverse colon in 18（22.2%）patients, in hepatic flexure in 42 （51.9%）and in ascending colon in 21（25.9%）.The success rate of stenting was 100%（81/81）, and endoscopic decompression using SEMS placement was technically successful in 78 of 81 patients（96.3%）.92.3%（72/78）patients underwent radical surgery 8 ± 1 days after stenting, among whom 5 underwent simultaneous hepatic metastasis foci resection and 3 others received partial resection of duodenum.Incidence of postoperative complications was 4.2%（3/72）, including one case of poor healing and 2 cases of cardiopulmonary complications, which were all cured with conservative treatments.No perioperative death occurred.Conclusion Management of acute proximal colon obstruction due to colon carcinoma by using SEMS placement is effective and safe, which can be considered as a bridge method before curative surgery. Key words: Colonic neoplasms; Intestinal obstruction; Endoscopes; Stents; Drainage