Stenting as a Bridge to Surgery or a Palliative Treatment.

Endoscopic stenting of the colorectum has emerged as a viable alternative to surgical interventions in a selected group of patients. The main indication for stenting is bowel obstruction. As such stenting can be used to palliate patients with metastatic disease or bridge patients to surgical intervention. The main advantages of stenting in the emergency setting include lower morbidity and mortality, lower incidence of stoma formation, shorter hospitalization, and better quality of life. For patients with unresectable disease and short life expectancy, stenting can be considered. However, for patients with longer life expectancy, the potential long-term complications of a metal stent such as erosion, migration, or obstruction have engendered debate whether such patients are better served by operative intervention. Stenting as a bridge to surgery is an alternative to surgery in patients who are high risk for emergency surgery but concerns remain regarding its impact on oncologic outcome in potentially curable patients.