Acute obstructing left-sided colonic lesions: Role of preoperative endoscopic colonic stent insertion

Abstract

Background: Malignant obstruction due to left-sided colonic malignant lesions is an acute emergent situation which is always dealt with by emergent celiotomy and colostomy for salvage of patient life. Colostomy is considered life-saving in such situations, yet it is of undesirable psychological feedback impressions for patients. The aim of this work is to describe our experience with the use of colonic stent in left-sided malignant obstruction, as a good step to relieve the obstruction, and hence to proceed for one-step resection anastomosis with primary repair without the need for colostomy, which is in itself of good impact for psychological satisfaction and salvage of patient. Patients and Methods: Out of 20 patients with left-sided colonic obstruction, 9 patients were dealt with colonic stent, of them 7 patients had one-step procedure with either left hemicolectomy or sigmoidectomy, and 11 had emergent surgical interference with colostomy. Results: Seven of nine patients had a successful laparoscopic colonic stent, and followed by a successful one-step surgical procedure, two of nine patients had unsuccessful laparoscopic stent with emergent exploration and colostomy. Conclusion: Colonic stent for the left malignant obstruction represents a valuable procedure for one-step resection and primary anastomosis without the need for colostomy.