Park Jun Seok, Kim Beom Gyu, Chang In Taik, Choi Yoo Shin, Kwak Byung Kook, Shim Hyung Jin, Kim Hyun Ho, Kim Jin Soo
Division of Colorectal Surgery, Department of Surgery, Kyungpook National University Hospital, School of Medicine, Daegu, Korea.
Surg Laparosc Endosc Percutan Tech. 2009 Oct;19(5):e202-5. doi: 10.1097/SLE.0b013e3181badb00.
In cases of proximal colonic obstruction, the long distances and the tortuosity of the distal bowel make it difficult to advance and position the stent in the target lesion. We report 2 cases of stent placement for malignant obstruction of the proximal colon in which access was obtained through percutaneous retroperitoneal colostomy. In these cases, we initially tried to place a stent through the rectum under endoscopic guidance, but it was not possible to reach the lesion. We then decided to cross the lesion through percutaneous puncture of the retroperitoneum. The procedures were completed without complications and the patients' symptoms improved. A percutaneous retroperitoneal approach for the deployment of colonic stents has not been described earlier in the literature. We suggest that our technique provides an alternative means of colonic decompression in cases in which conventional retrograde methods fail to provide acceptable palliation in nonsurgical candidates.
