For these reasons, emergency management of this kind of condition is characterized by a high morbidity (40%-60%) and mortality rate (3%-19%) but, for some authors, also 27%-40%, considering that the mortality rate for the same operation performed electively ranges from 0.9%-6%. These conditions are a worse prognostic factor for elderly patients with high American Society of Anesthesiologists (ASA) or Acute Physiology and Chronic Health Evaluation score or with locally advanced or metastatic cancer (almost 40% of this kind of patients) above all.

Bowel obstruction leads to some complications like dehydration, hypovolemic shock, renal or pulmonary acute failure, intestinal perforation, peritonitis etc. Colorectal cancer causes a complete or incomplete obstruction in 8%-29% of cases and obstruction represents 85% of surgical emergencies for colon cancer. In the other 28 cases (80%), we performed bowel anastomosis at the same time as resection, employing a temporary ileostomy only in 5 cases.ĬONCLUSION: Colorectal stenting transforms an emergency operation in to an elective operation performable in a totally laparoscopic manner, limiting the confection of colostomy with its correlated complications.Ĭolorectal obstruction represents a common problem due to pelvic neoplasms, such as gynecological, prostatic, colorectal and urinary bladder in 90% of cases or due to bowel inflammatory conditions, such as Crohn’s disease and ischemic or diverticular stenosis. We performed a terminal stomy in only 7 patients out of 35, 6 colostomies and one ileostomy (in a total colectomy). In 14% of cases (5 patients), resection was performed by open surgery due to the high American Society of Anesthesiologists score and the elderly age of patients (median age of 89 years). RESULTS: Surgical resection was totally laparoscopic in 69% of cases (24 patients) while 17% (6 patients) of cases were video-assisted due to the local extension of cancer with infiltrations of surrounding structures (urinary bladder in 2 cases, ileus and iliac vessels in the others). Obstruction was primitive colorectal cancer in 45 cases (93.7%) and benign anastomotic stricture in 3 cases (6.3%). All patients enrolled in our study were diagnosed with an intestinal obstruction originating from the colorectal tract without bowel perforation signs. METHODS: From March 2003 to March 2009 in our surgical department, 48 patients underwent endoscopic stenting for colorectal occlusive lesion: 30 males (62.5%) and 18 females (37.5%) with an age range from 40 years to 92 years (median age 69.5). AIM: To verify the clinical results of the endoscopic stenting procedure for colorectal obstructions followed by laparoscopic colorectal resection with “one stage anastomosis”.

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