Question

Role of palliative stenting (SEMS) in colonic cancer.

Hint:

SEMS provides a safe, effective, and less invasive option for managing colonic obstruction in patients with advanced cancer.

Answer 1

Palliative stenting using self-expanding metal stents (SEMS) is a minimally invasive procedure employed to relieve obstruction in patients with advanced colonic cancer. This technique is used when surgery is not feasible or as a bridge to surgery.
Step 1: Indications for Palliative Stenting:
1. Relief of Obstruction: SEMS can relieve colonic obstruction caused by tumors, improving symptoms such as pain, vomiting, and inability to pass stool.
2. Non-Surgical Candidates: For patients who are not candidates for surgery due to advanced cancer or poor performance status, SEMS provides an option to restore colonic patency.
3. Bridge to Surgery: In some cases, SEMS can be used temporarily to decompress the colon before surgery, allowing for a safer surgical procedure.
Step 2: Benefits and Risks:
1. Benefits: SEMS placement is associated with fewer complications, shorter recovery times, and lower hospital costs compared to traditional surgical procedures.
2. Risks: Potential complications include stent migration, perforation, and re-obstruction. Regular monitoring is essential.