Colorectal stenting for malignant and benign disease: outcomes in colorectal stenting.

INTRODUCTION

Self-expanding metal stents are now an established treatment for malignant colonic obstruction. Favorable outcomes have been reported both for cancer palliation and treatment of acute obstruction as a "bridge" to surgery. However, little data exists regarding the use of stents for benign colonic obstruction.

METHODS

All cases of colonic stent insertion occurring between December 1996 to October 2002 were reviewed. During the study period, 36 patients with malignant obstruction and 6 patients with benign obstructive disease underwent placement of self-expandable stents using a combined endoscopic and fluoroscopic technique.

RESULTS

Stent placement was successful in 36 of 42 patients (86 percent). Complications occurred in 16 of 36 patients (44 percent): migration (n = 7), reobstruction (n = 5), perforation (n = 2), fistula formation (n = 1), and stent fracture (n = 1). Stent placement was successful in 100 percent of patients with benign strictures but poststent migration was frequent (2/6).

CONCLUSIONS

Stent insertion provided an effective outcome in patients with malignant colonic obstruction as a palliative and preoperative therapy. Although a relatively high migration rate was observed in patients with benign strictures, stenting was still effective in providing luminal patency (median follow-up, 7.5 months). Stenting should be considered as a first-line treatment for malignant strictures and as a potential therapy for selected benign strictures.