Radiology, Vol 198, 761-764, Copyright © 1996 by Radiological Society of North America

ARTICLES

Colorectal obstruction: treatment with metallic stents

A Mainar, E Tejero, M Maynar, H Ferral and W Castaneda-Zuniga
Department of Surgery, Hospital Central del Insalud de Soria, Spain.

PURPOSE: To evaluate the usefulness of self-expandable metallic stents in the treatment of acute colonic obstruction secondary to colorectal neoplasm. MATERIALS AND METHODS: Stents were placed in 12 patients with clinical and radiologic signs of acute colonic obstruction. After symptom improvement, patients underwent radiologic staging. Single- stage surgery was performed in patients without disseminated disease. RESULTS: Stent placement was successful in all patients. Signs and symptoms of intestinal obstruction resolved within 24 hours of stent placement in 10 patients (83%). In two patients with massive bowel dilation, improvement was evident 2 and 4 days after stent placement. Ten patients underwent elective single-stage surgery with partial colonic resection and creation of a primary end-to-end anastomosis without major complications. In two patients with disseminated neoplastic disease, stent placement was considered the primary palliative treatment. CONCLUSION: Metallic stent placement to relieve acute colonic obstruction secondary to colorectal carcinoma is a safe therapeutic alternative, allowing single-stage surgery in suitable cases. In patients who are not surgical candidates it is an adequate palliative option.

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