Use of self-expanding metal stents for palliation of rectosigmoid cancer.

ABSTRACT

BACKGROUND: Patients with large bowel obstruction can be palliated by colostomy or by endoscopic modalities that restore luminal patency. The clinical results of a series of patients with rectosigmoid cancer in whom self-expanding metal stents were inserted at endoscopy are presented. METHODS: Thirty-seven patients with symptoms related to obstructive rectosigmoid adenocarcinoma were treated by endoscopic insertion of self-expanding metal stents. RESULTS: Metal stents were correctly placed in 36 of 37 patients (97%) with no immediate complications. Early dislodgment of the stent (within 1 week) was observed in 3 cases. The remaining 33 patients (92%) were followed for a median of 7 months (3 weeks-33 months). In 28 patients (78%) there was long-term restoration of luminal patency and disappearance of obstructive symptoms without further treatments. They experienced no pain, tenesmus, or incontinence during the follow-up period. The incidence of complications (early and late) and the mortality rate related to the procedure were 22% and 3%, respectively. CONCLUSIONS: Endoscopic metal stents can be considered a simple and effective solution for long-term palliation of rectosigmoid cancer.