Published online Feb 25, 2016. doi: 10.4253/wjge.v8.i4.198
Peer-review started: August 22, 2015
First decision: October 13, 2015
Revised: December 7, 2015
Accepted: December 18, 2015
Article in press: December 21, 2015
Published online: February 25, 2016
Processing time: 186 Days and 15 Hours
Colorectal cancer is one of the commonly encountered cancers across the Western World. In United Kingdom, this constitutes third most common ranked cancer and second most common ranked cause of cancer related deaths. Its acute presentation as a malignant colonic obstruction imposes challenges in its management. Colonic stent has been used for many years to alleviate acute obstruction in such cases allowing optimisation of patient’s physiological status and adequate staging of cancer. In this review, current literature evidence regarding use of colonic stent in acute malignant colonic obstruction is critically appraised and recommendations on the use of colonic stent are advocated.
Core tip: Although colonic stents have been used for years to treat acute malignant colonic obstructions, current evidence based on the systematic review and randomised controlled trials do raise concerns about its impact on the long term outcomes. Its use has not been recommended in acute suspected malignant colonic obstruction as a bridge to surgery due to evidence of its impact on recurrence rates; however there is enough evidence to suggest its use as a palliation. In patients with multiple co-morbidities with high American Society of Anaesthesiologists grades, colonic stent may be considered as an alternative option to emergency surgical procedure as a bridge.