Large bowel obstruction due to colorectal carcinoma can be safely treated by colonic stent insertion - case series from a UK district general hospital

Abstract.

Aim:  The aim of this study is to audit our outcomes and experience of colonic stent insertion for malignant bowel obstruction.

Method:  Retrospective audit of all stent insertions in a single district general hospital between August 2003 and December 2009. All patients had presented with acute bowel obstruction caused by malignant colorectal disease and details were collected prospectively and contemporaneously onto a database. Stent insertion was a combined endoscopic and fluoroscopic procedure involving a colorectal surgeon and consultant radiologist.

Results:  Stenting was attempted on 62 occasions in 54 patients. The technical success rate was 86% and clinical success rate 84%. The indications for stenting were for relief of acute bowel obstruction, palliation and as a bridge to surgery. There were complications in fourteen cases (22.5%) including three perforations and one peri-operative mortality. There were three cases of stent migration, six cases of re-stenosis and two stents became impacted with stool. There were no incidents of acute or delayed haemorrhage in any patients.

Conclusion:  Our experience shows that stenting for obstructing colorectal cancer is a safe and effective method of alleviating acute and impending bowel obstruction and can be provided safely and effectively in a district general hospital.

© 2012 The Authors Colorectal Disease © 2012 The Association of Coloproctology of Great Britain and Ireland