[Treatment with self-expanding metallic enteral stents in occlusion caused by neoplastic stenosis of the sigmoid and rectum].

From January 1999 to today 5 patients have been treated with self-expanding enteral stents for low intestinal occlusion in our General and Emergency Surgery Department. The patients' ages ranged from 75 to 90 years. Their general clinical condition was precarious and the emergency surgical treatment necessary was at very high risk. After a brief period of clinical monitoring the patients were submitted to a colonoscopy which revealed a tight neoplastic stenosis in the lowest portion of the colon. Self-expanding enteral stents measuring 9 by 20 mm were implanted in 4/5 patients, while, in the fifth patient, in view of the extent of the cancer, an oesophageal enteral stent measuring 12 by 23-28 mm was used. Over the following 24 hours we observed canalization and consequent disocclusion of the colorectum. It was thus possible to readjust the altered metabolic parameters, improve the respiratory and circulatory compliance and begin the study and the staging of the malignancy. Only two patients in acceptable general condition were submitted to radical surgery, while the other three were referred to our oncological radiotherapy centre. On the basis of this preliminary study we believe that in given clinical conditions and in a situation of emergency the use of self-expanding enteral stents, when indicated, is the only therapeutic measure capable of avoiding surgery carrying a very high risk and of creating the basis for appropriate, in-depth study of the cancer. In addition, it enables a better balance to be restored in the patient's general condition.