Preoperative total colonic observation after self-expandable metallic stenting in patients with malignant colorectal obstruction

Abstract

The use of a self-expandable metallic stent (SEMS) as a bridge to surgery (BTS) in obstructive colorectal cancer (OCC) enables restoration of patients' condition and preoperative evaluation of the entire colon. We investigated the safety and efficacy of total colonoscopy after stenting as a BTS at our hospital. Of the 129 patients who underwent SEMS placement as a BTS for OCC from July 2012 to February 2021, total colonoscopy was performed in 94 patients (73%). Synchronous colorectal cancer was detected in 47 lesions in 30 patients (32%); 26 of these lesions were resected concurrently during surgery of the main lesion and 20 lesions were resected endoscopically. No adverse events associated with SEMS placement and endoscopic examination were observed. In OCC patients, it was considered safe and beneficial to perform total colonoscopy after stenting, keeping in mind the possibility of synchronous multiple colorectal cancers.