Effect Of Colonic Stenting In Treating Malignant Colorectal Obstruction

ObjectiveBowel obstruction is one of the most common,emergent and severe complications of colorectal cancer patients.Bowel obstruction caused by colorectal cancer is usually treated with emergency operation,which often leads to higher mortality and more complications.Colonic stents can relieve the obstruction and restore the intestinal function quickly,while transform emergency operation to safer elective surgery.In the present study,we investigate the efficacy of endoscopic colonic stenting in treating malignant colorectal obstruction,and compare the differences between emergency surgery and stenting followed by elective surgery.Methods26 patients who underwent colonic stenting for malignant colorectal obstruction during June,2012 to Jan,2017 in our hospital were collected.The clinical efficacy and complications were reviewed and analyzed.14 patients with colonic stenting followed by elective surgery for left-sided malignant colorectal obstruction was the study group,and 19 patients who underwent emergency surgery for left-sided malignant colorectal obstruction during the same period was the control group,the clinical efficacy and complications were compared.ResultsPlacement of stent was technically successful in 100%(26/26)and clinically successful in 96.15%(25/26)of all the cases.Stent-related complications included one perforation(3.85%),one reobstruction(3.85%),and two hematochezia(7.69%),with no other severe complications.The study group performed better in rate of 1-stage surgery(50.00%vs.0 P=0.0001)stoma formation(57.14%vs.100%P=0.003)?laparoscopic surgery(85.71%vs.0 P=0.000)?ICU admission(7.14%vs.52.63%,P=0.009)and blood loss(P=0.002)than the control group.In aspects of postprocedural complications,first hospitalization time and cost,the two groups showed no significant difference(P>0.05).ConclusionEndoscopic colonic stenting is safe and reliable in treatment of malignant colorectal obstruction,which brings less trauma and fewer complications.It has great advantages both as a bridge to surgery or as a palliative treatment.