[Ileus in colorectal carcinoma. Preoperative implantation of self-expanding metal stents and early elective surgery as an alternative to emergency surgery].

INTRODUCTION

The objective of this study was to evaluate preoperative decompression with self-expanding metallic stents in patients with acute bowel obstruction due to colorectal carcinoma.

METHODS

In 28 patients, admitted to our clinic between January 1996 and May 1999 with suspicion of acute colonic obstruction caused by a colorectal carcinoma, we attempted to insert under fluoroscopic control a self-expanding metallic stent in the stenosis. After successful relief of obstruction, an elective one-stage surgical procedure followed.

RESULTS

The stent application was technically successful in 21 patients. In 19 patients symptom relief was reached within 2 days. One of these patients died perioperatively and two patients developed an anastomotic leakage. In eight of the other nine patients, in whom decompression was not possible, an emergency surgical procedure was performed; four of these patients died perioperatively. In only one of the five patients who survived, could a surgical procedure without an enterostoma be performed.

CONCLUSION

In cases of acute malignant colorectal obstruction, preoperative stent application under fluoroscopic control is a reliable method to allow single-stage surgical resection without requiring a protective enterostoma.