KEY POINTS IN THE TECHNIQUE OF COLONIC STENT PLACEMENT FOR MALIGNANT COLORECTAL OBSTRUCTION

Abstract

Stent (SEMS : self-expandable metallic stent) treatment for the colon and rectum was finally covered by the public health insurance system in Japan starting in 2012. This review describes the present conditions and key points in the technique of colonic stent placement. The current indication for colonic stent placement in Japan is malignant colorectal stenosis including palliation and bridge to surgery (BTS).

In palliation, patients with colorectal obstruction can avoid colostomy when a colonic stent can be introduced.

In patients who undergo BTS, short duration of hospitalization, reduced postoperative complications, reduced colostomy rate and reduced mortality rate are expected in comparison with those who undergo emergency surgery. Although it has been reported that the complication rate is low, adequate preparation and obtaining informed consent are important because complications can still occur during colonic stent placement. There are some tips and points to be taken into consideration in order to perform a safe procedure. The occurrence of complications can be minimized by following these guidelines. The Colonic Stent Safe Procedure Research Group, one of the subordinate organizations of the Japanese Society for Gastrointestinal Endoscopy, has put together a set of mini-guidelines for colonic stent placement and the mini-guidelines have been published on the Society’s website.