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Stenting as first‐line management for all patients with nonperforating left‐sided obstructing colorectal cancer
Author(s) -
Warden C.,
Stupart D.,
Goldberg P.
Publication year - 2013
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/codi.12206
Subject(s) - medicine , colorectal cancer , general surgery , cancer
Aim Since 2005, we have used self‐expanding metal stents ( SEMS ) as primary treatment for all patients with left‐sided obstructing colorectal cancer without evidence of perforation. The purpose of this study was to assess the safety and efficacy of this treatment. Method This was a prospective study of consecutive patients with left‐sided obstructing colorectal cancer without perforation or peritonitis treated between J anuary 2005 and J une 2009. SEMS placement was attempted in all cases. Emergency surgery was reserved for patients in whom a stent placement failed. After successful decompression, surgery was offered to patients with potentially curable disease. Results Seventy‐seven patients were included, with successful SEMS placement in 60/77 (78%) patients, 25 as a bridge to surgery and 35 for palliation. Immediate complications occurred in two (3%) cases. There was no mortality. Of 35 patients in whom SEMS was for palliation, 32 (91%) avoided surgery altogether. A stoma was fashioned in 5 (8.3%) of the 60 patients who were successfully stented, and in 12 (71%) of the 17 patients in whom stenting failed ( P = 0.0001). Conclusion A SEMS ‐based management protocol for patients with large bowel obstruction due to colorectal cancer is safe and effective.