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Endoscopic Stenting for Malignant Colorectal Obstruction

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The SAGES Manual Operating Through the Endoscope

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Abstract

Emergency surgery in the setting of a malignant large bowel obstruction carries a significant risk of morbidity and mortality. The introduction of endoscopic stenting as both a temporizing and palliative measure provides an opportunity for non-operative management in patients who would otherwise require an emergent diverting ostomy. Placement of the stent can act as a bridge to surgery, thereby allowing for completion of staging, decompression of colonic contents, and symptomatic relief. As for patients presenting with unresectable disease, endoscopic stents permit an earlier return to chemotherapy and improved quality of life. Stents are best placed by experienced operators using a combination of both endoscopic and fluoroscopic visualization. Following stent placement, patients are at risk for perforation (that may result in worsening oncologic outcomes), stent migration or obstruction, and may ultimately require replacement or surgical intervention. This chapter will review the outcomes surrounding endoscopic stent use for large bowel obstruction from colorectal cancer.

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Author information

Authors and Affiliations

  1. Department of Colorectal Surgery, Cleveland Clinic, Cleveland, OH, USA

    Arielle Kanters, Michael Valente & Scott R. Steele

Authors
  1. Arielle Kanters
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  2. Michael Valente
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  3. Scott R. Steele
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Corresponding author

Correspondence to Arielle Kanters .

Editor information

Editors and Affiliations

  1. Digestive Disease Inst, A100, Cleveland Clinic, Cleveland, OH, USA

    Matthew Kroh

  2. Department of Surgery, University of South Florida, Tampa, FL, USA

    Salvatore Docimo Jr.

  3. BariJuve Surgical, Hoffman Estates, IL, USA

    Sofiane El Djouzi

  4. Department of Surgery, University of Wisconsin Health, Madison, WI, USA

    Amber Shada

  5. Center for Advanced Surgery, The Oregon Clinic, Portland, OR, USA

    Kevin M. Reavis

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Kanters, A., Valente, M., Steele, S.R. (2023). Endoscopic Stenting for Malignant Colorectal Obstruction. In: Kroh, M., Docimo Jr., S., El Djouzi, S., Shada, A., Reavis, K.M. (eds) The SAGES Manual Operating Through the Endoscope. Springer, Cham. https://doi.org/10.1007/978-3-031-21044-0_12

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  • DOI: https://doi.org/10.1007/978-3-031-21044-0_12

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-21043-3

  • Online ISBN: 978-3-031-21044-0

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