ABSTRACT

OBJECTIVE:

Approximately 10 to 20% of colon and rectal cancer patients present with partial, and 8 to 29% with complete obstruction.Curative operation can be performed in only 50% of those patients and operative mortality is around 40 to 50%. In this study we report 8 patients in whom metalic self expandable stents used for their obstructing sigmoid colon or rectal cancer.

METHODS:

After rectal enema, patients were performed colonoscopy under conscious sedation. Glide wire negotiated from tumor to the proximal bowel. Metallic stents (Wallfl ex- BostonScientifi c) were placed to obstructed segment.Th e size of the stents were determined by CT length of the tumor.If stent could not negotiated through tumor dilator were used befor stent deployment.

RESULTS:

Tumor sites were rectum (1 in upper, 3 in middle or lower third) in 4 patients, and sigmoid tumor in other 4 patients. In 4 patients the initial aim of stenting were palliation. But in 2 of those patients operation required due to complication related to the procedure (cecal perforation in one, and proximal stent migration in the second patient). In other 4 patients for whom stents were used for bridging to surgery, operatin performed within 24 hours. Low anterior resection were performed in 2, left hemicolectomy and abdominoperineal resection performed in other two patients, and no complications encountered in this group.

CONCLUSION:

Stenting obstructing advanced tumors may preclude operation in these patient who likely to have comorbidity. Bridging patients in whom curative operation seems to be possible, prevents emergency operation and its complications Besides, two stage operation will not be a “should be” in most of the cases.