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Placement of self-expanding metal stents for acute malignant large-bowel obstruction: A collective review

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The purpose of this study was to review our experience with self-expanding metal stents as the initial interventional approach in the management of acute malignant large-bowel obstruction.


Twenty-six patients who underwent placement of colonic stents at our institution between June 1994 and June 2000 were identified and reviewed.


In 14 patients, the stents were placed for palliation, whereas in 12, they were placed as a bridge to surgery. In 22 patients (85%), stent placement was successful on the first occasion. In the remaining four individuals, one was successfully stented at the second occasion, and three required emergency surgery. Nine of the 12 patients (75%) in the bridge-to-surgery group underwent elective colon resection. In the palliative group, four patients (29%) had reobstruction of the stents, and in one (9%), the stent migrated. In the remaining nine patients (64%), the stent was patent until the patient died or until the time of last follow-up (median, 156 days).


In our experience with 26 patients who developed a complete bowel obstruction as a consequence of a malignant tumor, placement of colonic stents to achieve immediate nonoperative decompression proved to be both safe and effective. Subsequent elective resection was accomplished in the majority of resectable cases.

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  1. Wright KC, Walace S, Charnsangavej C, Carrasco CH, Gianturco C. Percutaneous endovascular stents: an experimental evaluation.Radiology 1985;156:69–72.

    PubMed  CAS  Google Scholar 

  2. Kimura T, Yokoi H, Nakagawa, et al. Three-year follow-up after implantation of metallic coronary-artery stents.N Engl J Med 1996;334:561–6.

    Article  PubMed  CAS  Google Scholar 

  3. Badlani G. Role of permanent stents.J Endourol 1997;11:473–5.

    Article  PubMed  CAS  Google Scholar 

  4. Stohr S, Bollinger C. Stents in the management of malignant airway obstruction.Monaldi Arch Chest Dis 1999;54:264–8.

    PubMed  CAS  Google Scholar 

  5. Kozarek RA. Expandable endoprostheses for gastrointestinal stenoses.Gastrointest Endosc Clin North Am 1994;4:279–95.

    CAS  Google Scholar 

  6. Dohmoto M. New method—endoscopic implantation of rectal stent in palliative treatment of malignant stenosis.Endosc Digest 1991;3:1507–12.

    Google Scholar 

  7. Tejero E, Mainar A, Fernandez L, Tobio R, DeGregorio MA. New procedure for the treatment of colorectal neoplastic obstructions.Dis Colon Rectum 1994;37:1158–9.

    Article  PubMed  CAS  Google Scholar 

  8. Tejero E, Fernandez-Lobato R, Mainar A, et al. Initial results of a new procedure for treatment of malignant obstruction of the left colon.Dis Colon Rectum 1997;40:432–6.

    Article  PubMed  CAS  Google Scholar 

  9. Wholey MH, Levine EA, Ferral H, Castaneda-Zuniga W. Initial clinical experience with colonic stent placement.Am J Surg 1998; 175:194–7.

    Article  PubMed  CAS  Google Scholar 

  10. Mainar A, Tejero E, Maynar A, Ferral H, Castaneda-Zuniga W. Colorectal obstruction: treatment with metallic stents.Radiology 1996;198:761–4.

    PubMed  CAS  Google Scholar 

  11. DeGregorio MA, Mainar A, Tejero E, et al. Acute colorectal obstruction: stent placement for palliative treatment—results of a multicenter study.Radiology 1998;209:117–20.

    CAS  Google Scholar 

  12. Soonawalla Z, Thakur K, Boorman P, et al. Use of self-expanding metallic stents in the management of obstruction of the sigmoid colon.AJR Am J Roentgenol 1998;171:633–6.

    PubMed  CAS  Google Scholar 

  13. Dauphine CE, Tan PY, Beart RW Jr, Corman ML, Vukasin P. Self-expanding metallic stents in the management of lower gastrointestinal hemorrhage.Dis Colon Rectum (in press).

  14. Buechter KJ, Boustany C, Caillouette R. Surgical management of the acutely obstructed colon.Am J Surg 1988;156:163–8.

    Article  PubMed  CAS  Google Scholar 

  15. Deans GT, Krukowski ZH, Irwin ST. Malignant obstructions of the left colon.Br J Surg 1994;81:1270–6.

    Article  PubMed  CAS  Google Scholar 

  16. Serpell JW, McDermott FT, Katrivessus H, Hughes ESR. Carcinomas of the colon causing intestinal occlusion.Br J Surg 1989;2:549–54.

    Google Scholar 

  17. Ohman U. Prognosis in patients with obstructing colorectal carcinoma.Am J Surg 1982;143:742–7.

    Article  PubMed  CAS  Google Scholar 

  18. Gandrup P, Lund L, Balslev I. Management of acute malignant large bowel obstruction.Eur J Surg 1992;158:427–30.

    PubMed  CAS  Google Scholar 

  19. Ravo B, Ger R. Temporary colostomy—an outmoded procedure? A report on the intracolonic bypass.Dis Colon Rectum 1985;28:904–7.

    Article  PubMed  CAS  Google Scholar 

  20. Murray JJ, Schoetz DJ, Coller JA, Roberts PL, Veidenheimer MC. Intraoperative colonic lavage and primary anastomosis in nonelective colon resection.Dis Colon Rectum 1991;34:527–31.

    Article  PubMed  CAS  Google Scholar 

  21. Wallis F, Campbell KL, Eremin O, Hussey JK. Self-expanding metal stents in the management of colorectal carcinoma—a preliminary report.Clin Radiol 1998;53:251–4.

    Article  PubMed  CAS  Google Scholar 

  22. Egozi L, Sorrento JJ, Golub R, Schultz EH. Complication of the intracolonic bypass.Dis Colon Rectum 1993;36:191–3.

    Article  PubMed  CAS  Google Scholar 

  23. Corman ML:Colon and Rectal Surgery. 4th ed. Philadelphia: Lippincott-Raven, 1998:684–93.

    Google Scholar 

  24. Keighley MRB, Williams NS.Surgery of the Anus, Rectum, and Colon. 2nd ed. London: W.B. Saunders Co., 1999:2185–8.

    Google Scholar 

  25. Rupp KD, Dohmoto M, Meffert R, Holzgreve A, Hohlbach G. Cancer of the rectum—palliative endoscopic treatment.Eur J Surg Oncol 1995;21:644–7.

    Article  PubMed  CAS  Google Scholar 

  26. Sardi A, Ojeda H, Barco E. Cryosurgery: adjuvant treatment at the time of resection of a pelvic recurrence in rectal cancer.Am Surg 1999;65:1088–91.

    PubMed  CAS  Google Scholar 

  27. Choo IW, Do YS, Suh SW, et al. Malignant colorectal obstruction: treatment with a flexible covered stent.Radiology 1998;206:415–21.

    PubMed  CAS  Google Scholar 

  28. Saida Y, Sumiyama Y, Nagao J, Takase M. Stent endoprosthesis for obstructing colorectal cancers.Dis Colon Rectum 1996;39:552–5.

    Article  PubMed  CAS  Google Scholar 

  29. Arnell T, Stamos M, Takahashi P, et al. Colonic stents in colorectal obstruction.Am Surg 1998;10:986–8.

    Google Scholar 

  30. Turegano-Fuentes F, Echenagusia-Belda A, Simo-muerza G, et al. Transanal self-expanding metal stents as an alternative to palliative colostomy in selected patients with malignant obstruction of the colon.Br J Surg 1998;85:232–5.

    Article  PubMed  CAS  Google Scholar 

  31. Binkert CA, Ledermann H, Jost R, et al. Acute colonic obstruction: clinical aspects and cost-effectiveness of preoperative and palliative treatment with self-expanding metallic stents-a preliminary report.Radiology 1998;206:199–204.

    PubMed  CAS  Google Scholar 

  32. Canon CL, Baron TH, Morgan DE, Dean PA, Koehler RE. Treatment of colonic obstruction with expandable metal stents: radiological features.AJR Am J Roentgenol 1997;168:199–205.

    PubMed  CAS  Google Scholar 

  33. Lobato RF, Pinto I, Maillo C, et al. Rectovesical fistula treated by covered self-expanding prosthesis.Dis Colon Rectum 1999;42:812–5.

    Article  Google Scholar 

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Correspondence to Marvin L. Corman MD.

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Dauphine, C.E., Tan, P., Beart, R.W. et al. Placement of self-expanding metal stents for acute malignant large-bowel obstruction: A collective review. Annals of Surgical Oncology 9, 574–579 (2002).

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