Endoscopic palliation of colorectal cancer

Patients with colorectal cancer often present with advanced disease and are sometimes candidates only for palliative therapies. Many of these patients present with subtotal or complete colonic obstruction. Self-expanding metal stents are now available to palliate obstructing or near-obstructing lesions of the large intestine, and their use is becoming commonplace. In patients with malignant large bowel obstructions without widespread disease, the placement of a colonic self-expanding stent can allow preoperative decompression and bowel preparation to allow for a one-stage surgical procedure. In patients with large bowel obstruction from advanced or widespread malignancies, as is much more commonly seen, colonic stents can be placed as purely palliative devices. Lasers also can play a role in the palliation of colorectal cancer, but their use as a sole means of palliation is declining.