Colonic stents: who, where, when

Large bowel obstruction can be caused by advanced colonic cancer, extracolonic obstruction or benign strictures. The technical success rate of colonic stents for the treatment of colorectal obstruction is about 87% with complications or technical failure at about 14%. Mortality associated with the procedure is <4%and perforation is 4.5%. This article will discuss who would benefit from colonic stents including bridge to surgery, palliation, benign strictures and who should be performing this procedure. The insertion of stents in the colon has been primarily studied in the left colon, although proximal obstruction will also be discussed. The timing of stent insertion, in relation to symptoms and chemotherapy, will be discussed.