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Colorectal cancer is one of the most common cancers worldwide, and although there is growing concern about screening and prevention, 10--15% of the cases still present with obstruction. The management of these cases is difficult and there is ongoing debate about the best standard of care for these patients. Surgery is the traditional option but the use of self-expandable metal stents (SEMS) has been reported in malignant colonic obstruction, either for palliation or as a bridge-to-surgery in patients with potentially curable colon cancer. The most recently published guidelines considered stents as the preferential treatment for palliation of obstructive colorectal cancer when feasible. On the other hand, about the issue of stents as a bridge-to-surgery they recommended against the use of SEMS as a standard treatment, considering emergent surgery as the first therapeutic option. According to these guidelines, SEMS as a bridge to surgery would be reserved for those patients with higher risk of post-operative mortality (ASA ≥III and/or age >70 years). The rationale behind these recommendations comes mainly from three randomized controlled trials (RCT),

To Stent or Not to Stent in Colorectal Cancer: That is Still the Question in Gastroenterology!