Endoprostheses for colonic strictures

The British Journal of Surgery
C A Akle

Abstract

Patients who present with large bowel obstruction often undergo emergency surgical intervention with its attendant risk of morbidity and death. A colostomy may be inevitable and this detracts from the patient's quality of life, especially when palliation is the only option. This review examines the possibility of a more conservative approach using metallic stents to relieve colonic obstruction, either as the first stage of a curative surgical procedure or for palliation without surgery. The various stents available are examined. Case reports show that relief of obstruction can be achieved in over 80 per cent of patients, allowing subsequent elective surgery or achieving palliation for several months. Complications are rare but include colonic perforation, particularly when predilatation of the stricture has to be performed. Such complications are generally recognized early and patients can proceed to surgery and colostomy, as would previously have been conventional treatment; on occasion a small leak may be treated conservatively with success. The advent of newer endoprostheses which do not require active dilatation may improve the rate of successful deployment and lessen the risk of perforation. The development of new endopros...Continue Reading

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Citations

May 5, 2007·Surgical Endoscopy·Stefano OlmiEnrico Croce
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