Colonic stenting

Colorectal stenting has been reported as an effective method of relieving colonic obstruction in the palliative setting for advanced cancer and in the preoperative setting as a bridge to surgery. Stenting can allow for an emergency operation to be converted to an elective operation. By decompressing the colon and allowing for medical optimization of the patient, self-expandable metal stent (SEMS) placement can transition a patient from a high-risk situation to a one-stage elective operation with potential primary resection and anastomosis. Stenting of select benign strictures is also accepted. In the hands of experienced advanced endoscopists, the placement of the stent has a high chance of technical and clinical success. In this chapter, we will discuss the indications and contraindications for stenting, types of stents available with advantages and disadvantages, up-to-date literature on success rates, short- and long-term complication rates, and cost. Finally, we will discuss what we feel are technical pearls for successful stenting.