Biodegradable stent insertion for ischaemic colorectal strictures: Tiger country

ABSTRACT

We describe our initial experience with the use of biodegradable (BD) stents in benign ischemic colorectal strictures with two cases. The first case is of a 40-year-old male with a history of retroperitoneal sarcoma who developed a benign stricture in the descending colon postsurgical and radiotherapy treatment. Balloon dilation was required in order to pass the delivery system. The patient experienced significant pain postdeployment and post procedure computed tomography scan demonstrated a small perforation requiring an emergency laparotomy. The second case is a 61-year-old male with a history of retroperitoneal sarcoma who also developed an ischemic stricture in the descending colon after surgical excision. Using a combined fluoroscopic and endoscopic approach 3 separate BD stents were inserted over a 17-month period improving clinical symptoms of intermittent obstruction. These symptoms reoccurred after stent disintegration and the patient was definitively managed surgically with colostomy formation. The use of BD stents, although appealing, does not provide an adequate long term result. Additionally, more flexible, smaller calibre systems are required for deployment in tortuous environments.