A Review of Colonic Stenting for Malignant Colonic Obstruction

Abstract

Stent (SEMS : self-expandable metallic stent) treatment for malignant colonic obstruction has been available since 2012 in Japan, and is covered by the public health insurance system. In this review, I describe the present conditions and future prospects of the procedure, based on data from the literature. The current indication in Japan is malignant colorectal stenosis.
Stent use in palliative treatment, avoidance of colostomy, release of obstruction, shorter duration of hospitalization, and better quality of life have been widely reported. Moreover, stent use can be a bridge to surgery (BTS), enabling shorter duration of hospitalization, and reduced postoperative complications, colostomy rates, and mortality rates, as compared to emergency surgery. Although the reported complication rate is low, adequate preparation and informed consent are important because complications can still occur. There are some tips and points to consider to ensure a safe procedure with minimal adverse incidents. The Colonic Stent Safe Procedure Research Group has compiled information on the colonic stent, and the guidelines have been published on the society's website. Reference to the guidelines before performing any procedure is recommended.