2005 Volume 47 Issue 8 Pages 1548-1553
Disseminated intra-abdominal malignancies of recurrent or advanced gastric cancer can also cause colonic or rectal obstruction by extrinsic compression. Surgical treatment is usual option to treat malignant bowel obstruction. However, this usually involved emergency surgery on poor-risk and clinically unstable patients with unprepared bowels. In many cases, particu-larly in palliative surgery, the creation of colostomy is inevitable. The self-expandable metallic stent (SEMS) has been found to be effective in relieving colorectal obstruction, both as a palliative treatment for unresectable tumor and as a temporary measure for subsequent surgery. We reported our preliminary experience with the use of endoscopic self-spandable Ultraflex stents as a palliative treatment for colorectal obstruction for peritoneal dissemina-tion of gastric cancer. All SEMS of five patients with colorectal obstruction were enplaced successfully and covered the obstructive lesions satisfactorily. Bowel function returned within 24 hours, and per oral feeding began again after a day. Four patients of them died of the disease 1 to 14 months after placement of SEMS. The complication of other one was dislocation of SEMS, because of progressive response of recurrence gastric cancer with peritoneal dissemina-tion after chemotherapy of S-1. No one complained of abdominal discomfort and incontinence of stool. The use of SEMS can achieve rapid and effective non-surgical means to relieve colorectal obstruction. It provided good palliation for unresectable peritoneal dissemination of gastric cancer that causes colorectal obstruction.
