Colonic stenting: When and how

Since the first report in 1990 by Dohomoto et al., endoluminal stenting of the colorectum has become a viable alternative to surgery. For patients with unresectable disease, stent implantation can be considered, avoiding the need for colostomy and has been associated with a better quality of life. The long-term outcomes of palliative stenting has shown favorable results. Emergency surgery in patients with colonic obstruction is associated with significant morbidity and mortality rates. Stenting as bridge to surgery is now an alternative to emergency surgery despite the uncertainity of its long-term oncologic safety. Colonic stenting has been used in benign colonic obstructions but the data on long-term outcomes remains limited. The appropriate decision for stent or surgery in the setting of acute colonic obstruction requires a structured approach.