Published online Mar 16, 2019. doi: 10.4253/wjge.v11.i3.193
Peer-review started: January 17, 2019
First decision: January 26, 2019
Revised: January 29, 2019
Accepted: February 13, 2019
Article in press: February 13, 2019
Published online: March 16, 2019
According to the American Cancer Society and Colorectal Cancer Statistics 2017, colorectal cancer (CRC) is one of the most common malignancies in the United States and the second leading cause of cancer death in the world in 2018. Previous studies demonstrated that 8%-29% of patients with primary CRC present malignant colonic obstruction (MCO). In the past, emergency surgery has been the primary treatment for MCO, although morbidity and surgical mortality rates are higher in these settings than in elective procedures. In the 1990s, self-expanding metal stents appeared and was a watershed in the treatment of patients in gastrointestinal surgical emergencies. The studies led to high expectations because the use of stents could prevent surgical intervention, such as colostomy, leading to lower morbidity and mortality, possibly resulting in higher quality of life. This review was designed to provide present evidence of the indication, technique, outcomes, benefits, and risks of these treatments in acute MCO through the analysis of previously published studies and current guidelines.
Core tip: This review was designed to provide present evidence of the indication, technique, outcomes, benefits, and risks of colon stenting and emergency surgery in acute malignant colonic obstruction through the analysis of previously published studies with 1A evidence and current guidelines.