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World J Gastrointest Oncol. Jan 15, 2016; 8(1): 113-120
Published online Jan 15, 2016. doi: 10.4251/wjgo.v8.i1.113
Role of self expandable stents in management of colorectal cancers
Erdinc Cetinkaya, Ahmet Bulent Dogrul, Mehmet Bulent Tirnaksiz
Erdinc Cetinkaya, Department of General Surgery, Ankara Numune Education and Training Hospital, 06100 Sıhhiye, Ankara, Turkey
Ahmet Bulent Dogrul, Mehmet Bulent Tirnaksiz, Department of General Surgery, Hacettepe University Medical School, 06100 Sıhhiye, Ankara, Turkey
Author contributions: All authors contributed equally to this work (decision of the subject of the review, writing the article, critical revisions, and final approval of the article to be published).
Conflict-of-interest statement: There is no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
Correspondence to: Ahmet Bulent Dogrul, MD, Assistant Professor, Department of General Surgery, Hacettepe University Medical School, Hacettepe Mh., 06100 Sıhhiye, Ankara, Turkey. ahmetdogrul@yahoo.com
Telephone: +90-312-3051675 Fax: +90-312-3104071
Received: June 22, 2015
Peer-review started: June 22, 2015
First decision: September 17, 2015
Revised: October 1, 2015
Accepted: November 10, 2015
Article in press: November 11, 2015
Published online: January 15, 2016
Processing time: 206 Days and 16.4 Hours
Abstract

Acute malignant colorectal obstruction is a complication of colorectal cancer that can occur in 7%-29% of patients. Self-expanding metallic stent placement for malignant colorectal obstruction has gained popularity as a safe and effective procedure for relieving obstruction. This technique can be used in the palliation of malignant colorectal obstruction, as a bridge to elective surgery for resectable colorectal cancers, palliation of extracolonic malignant obstruction, and for nonmalignant etiologies such as anastomotic strictures, Crohn’s disease, radiation therapy, and diverticular diseases. Self-expanding metallic stent has its own advantages and disadvantages over the surgery in these indications. During the insertion of the self-expanding metallic stent, and in the follow-up, short term and long term morbidities should be kept in mind. The most important complications of the stents are perforation, stent obstruction, stent migration, and bleeding. Additionally, given the high risk of perforation, if a patient is treated or being considered fortreatmentwith antiangiogenic agents such as bevacizumab, it is not recommended to use self-expanding metallic stent as a palliative treatment for obstruction. Therefore, there is a need for careful clinical evaluation for each patient who is a candidate for this procedure. The purpose of this review was to evaluate self-expanding metallic stent in the management of the obstruction of the colon due to the colorectal and extracolonic obstruction.

Keywords: Colorectal cancer; Obstruction; Metallic stents; Self-expandable; Extracolonic obstruction

Core tip: Self-expanding metallic stent placement for malignant colorectal obstruction has gained popularity as a safe and effective procedure for relieving obstruction. This technique can be used in the palliation of malignant colorectal obstruction, as a bridge to elective surgery for resectable colorectal cancers, palliation of extracolonic malignant obstruction, and for nonmalignant etiologies such as anastomotic strictures, Crohn’s disease, radiation therapy, and diverticular diseases. In this review we aimed to evaluate the placement technique, indications and complications of self-expanding metallic stent in colorectal obstructions.