Transendoscopic balloon dilatation of complete colonic obstruction

Abstract

Complete colonic obstruction secondary to colorectal cancer has traditionally been managed by a staged approach. Simple diversion or resection with colostomy is performed followed by reestablishment of intestinal continuity at a subsequent operation. The use of a transendoscopic technique of balloon dilatation for complete malignant obstruction in the management of three patients is discussed. Successful balloon dilatation allowed for complete bowel preparation and either elective single-stage resection or controlled Nd:YAG laser palliation in a clean field. Although not applicable to all clinical situations, balloon dilatation is a valuable adjunct in the management of obstructing colorectal cancer. Relief of obstruction by tumor dilatation allows 1) correction of fluid and electrolyte abnormalities, 2) administration of a complete bowel preparation, 3) single-stage resection and anastomosis, or 4) palliative laser photoablative therapy that avoids the need for colostomy.