Therapeutic value of endoscopic metal stent implantation for left-sided malignant colorectal obstruction / 中华消化内镜杂志

ABSTRACT

Objective To investigate the therapeutic value of endoscopic implantation of metal stents for obstruction caused by left-sided malignant colorectal tumor.Methods Data of 29 patients with left-sided malignant colonic obstruction who underwent stenting from May 2007 to May 2011 were retrospectively analyzed.Results Self-expanding metal stents were successfully implanted in 27 patients.Symptoms of abdominal distention and vomiting subsided in these patients.The procedure failed in 2 patients (2/29,6.9％ ),because the guidewire failed to pass the colonic stricture due to edema and the length of the diseased colon.Technical success was achieved in 27 of total 29 patients (27/29,92.6％ ).Out of the 27 patients,stage Ⅰ primary left-sided colonic resection and anastomosis were successfully performed in 24 patients.Colonic perforation was found intraoperatively in 1 patient ( 1/27,3.7％ ) who subsequently recovered after operation.There was no death during the perioperative period with the average hospital stay of 11.7 days.A mean colonic stent patency for 5 months was observed in 3 patients who underwent palliative stenting only.Conclusion Endoscopic implantation of metal stents is effective for left-sided malignant colorectal obstruction.As a bridge to surgery,it facilitates sufficient bowel preparation for elective radical operation.