Endoscopic treatment of acute colorectal obstruction with self-expandable metallic stents

Experience in a community hospital
  • S. Soto
  • L. López-Rosés
  • A. González-Ramírez
  • A. Lancho
  • A. Santos
  • P. Olivencia



The purpose of this study was to evaluate the efficacy and security of treatment with self-expandable metallic stents for acute colonic obstruction.


Retrospectively, we analyzed our experience in placing colonic stents in patients with acute colonic obstruction. Sixty-two patients with malignant colon obstruction were sent to our hospital endoscopic unit from February 1999 through September 2003. The mean age was 75.21 years. A total of 63 self-expandable metallic stents were implanted. All procedures were done under endoscopic and fluoroscopic guidance.


Technical success was obtained in 58 patients (93.54%). Clinical improvement and resolution of the obstruction were confirmed in 56 of these 58 patients (96.55%) within 48–72 h. Sixteen complications were observed in 11 patients (19%). Twelve cases were minor complications: five patients had pain and rectal tenesmus, and there were seven cases of distal migration of the stent. Four patients (6.9%) had severe complications. Three patients underwent surgery to resolve colonic perforations and one patient developed a colovesical fistula 7 months after stent placement. The stent was used as a bridge to the elective surgery in 22 patients (37.93%). The mean time between stent placement and surgery was 7.66 days (range, 2–20). The stent was used as a definitive palliative treatment in 36 patients (62.07%).


Stenting was a useful treatment of acute malignant colonic obstruction. The use of stents as a “bridge to the elective surgery” allowed the intestinal preparation, general status restoration, and a one-stage operation with resection and primary reanastomosis. We have also used the stents as a definitive palliative treatment, avoiding surgery in those patients with a very widely metastatic disease or who cannot undergo operation because of comorbid underlying conditions.


Colorectal Endoscopy Therapeutic Palliation 


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Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • S. Soto
    • 1
  • L. López-Rosés
    • 1
  • A. González-Ramírez
    • 1
  • A. Lancho
    • 1
  • A. Santos
    • 1
  • P. Olivencia
    • 1
  1. 1.Gastroenterology UnitHospital Xeral de LugoLugo

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