Stent Insertion as a Bridge to One Stage Operation in Malignant Obstruction of Left Colon (6 cases)

ABSTRACT

Surgical treatment of acute malignant obstruction of the left colon is problematic due to the poor general state of patients, lack of bowel preparation, and the urgency of the procedure itself. A multistage approach including emergent diverting colostomy has traditionally been the method of surgical treatment for acute left sided colonic obstruction secondary to the tumor. However, these treatment efforts have been marred by an inability to complete the sequence of operations due to numerous medical co-morbidities in the patients. The use of a self expanding metallic stent to relieve colorectal malignant obstruction has been recently, described for the palliative purpose of relieving the obstruction and for converting emergency surgery into elective surgery following routine preoperative bowel preparation. Either a covered or uncovered expandable colorectal stent (Choo colorectal endoprosthesis; Sooho Medi-Tech, Seoul, Korea) was inserted by endoscopic and fluoroscopic guidance in 6 patients with acute malignant left-sided colonic obstruction. We present these 6 patients who underwent self expandable metallic stent insertion for the treatment of left sided malignant colonic obstruction as a bridge to a single operation.