James J Farrell1. 1. Department of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, California 90095, USA. jfarrell@mednet.ucla.edu
Abstract
PURPOSE OF REVIEW: Acute colonic obstruction due to malignancy is often a surgical emergency. Surgical decompression with colostomy with or without resection and eventual re-anastomosis has traditionally been the treatment of choice. These procedures have been associated with a significant morbidity and mortality rate. Preoperative colonic stenting is effective for decompressing the obstructed colon and may allow for surgery to be performed on an elective basis. RECENT FINDINGS: Although randomized clinical data are lacking, the role for preoperative stenting in the emergent management of acute malignant colonic obstruction has been supported by cost-effectiveness analysis studies and several pooled analyses that demonstrate efficacy and safety. SUMMARY: This review evaluates the latest developments in colonic stent technology, indications for use in the preoperative setting, and evidence to support their use in this setting.
PURPOSE OF REVIEW: Acute colonic obstruction due to malignancy is often a surgical emergency. Surgical decompression with colostomy with or without resection and eventual re-anastomosis has traditionally been the treatment of choice. These procedures have been associated with a significant morbidity and mortality rate. Preoperative colonic stenting is effective for decompressing the obstructed colon and may allow for surgery to be performed on an elective basis. RECENT FINDINGS: Although randomized clinical data are lacking, the role for preoperative stenting in the emergent management of acute malignant colonic obstruction has been supported by cost-effectiveness analysis studies and several pooled analyses that demonstrate efficacy and safety. SUMMARY: This review evaluates the latest developments in colonic stent technology, indications for use in the preoperative setting, and evidence to support their use in this setting.