Abstract
Endoscopic stenting with self-expandable metallic stents (SEMS) is a widely accepted procedure for the management of colonic obstruction due to the involvement of malignancies. This procedure has been reported to be an effective candidate for both palliative purposes and as a bridge to surgery. Because of its low invasiveness, this procedure had been selected along with bypass surgery or colostomy for patients with unresectable colonic obstructions. However, SEMS placement studies have only been able to be performed as clinical trials in Japan because the procedure was not yet covered by the government medical insurance system. SEMS placement for malignant colorectal obstruction started to be covered by the insurance system, and rapid increase of the use of this procedure is anticipated in Japan. SEMS placement is associated with severe complications, however, such as perforation and stent migration ; it is therefore necessary to establish a consensus for this procedure. The Japan Gastroenterological Endoscopy Society is currently attempting to build a common procedure, and we precisely report herein on the tips for the choice of catheter, guidewire, stent length and how to handle the scope.
