The use of enteral stents in colonic and gastric outlet obstruction

Background: Enteral stenting is emerging as a viable treatment option for malignant obstructions of the gastrointestinal (GI) tract. We describe our experience and review the literature on techniques and complications. Methods: A retrospective chart review of a single surgical service from 1998 to January 2002 was performed for all cases of endoscopic stenting for obstruction of the GI tract. Demographics, indications, success rate, complications, and outcomes were evaluated. Results: There were nine female and two male patients aged 31-88 years (mean, 64.6). Six stents were placed in five patients with malignant gastric outlet obstruction. Technical success was achieved in 100%, and all patients improved clinically. Seven stents were placed in six patients with colon obstruction. Technical success was achieved in 100%, and six of seven obstructions were relieved. There was one perforation, which required a colostomy. A review of the literature showed overall technical success rates as high as 100%, 80-100% improvement in obstructive symptoms, and a 0-30% complication rate. Complications include perforation (0-16%). bleeding, occlusion, migration, and pain. Conclusion: Enteral stenting is effective in relieving GI obstruction, but it carries a risk for perforation. It should be considered an option to gastroenteric bypass, colostomy, or resection in debilitated patients.