Enteral and colonic self-expanding metallic stents.

Self-expanding metal stents (SEMS) have changed the management of malignant gastrointestinal obstruction. In malignant gastroduodenal obstruction for which curative surgical resection is not possible, endoscopic placement of SEMS is an ideal option. Endoscopic placement of SEMS has a high rate of technical and clinical success and a low rate of complications. Most studies have shown better outcomes as compared with surgical diversion procedures. Similar to the gastroduodenal stent, colonic SEMS have a role in colonic malignancy, both as a palliative modality and as a bridge to surgery. Placement of colonic SEMS has been highly technically and clinically successful. Published series have reported low complication rates for SEMS, with excellent outcomes in the context of palliation as well as a bridge to surgical resection.