Endoscopic palliative therapy of an obstructing rectal cancer
Epublication WebSurg.com, Jun 2009;09(06). URL: http://websurg.com/doi/vd01en2661
Fifteen per cent of rectal cancers are unresectable because of local extension or metastasis. Endoscopic palliative treatments have been described to avoid surgical palliative procedures (ileostomy, colostomy), which inevitably affect the patient's quality of life. Endoscopic electrocoagulation, laser therapy and cryotherapy have been used for this purpose, but they need multiple therapeutic sessions: these have a high cost and cause patient discomfort. Permanent stenting with Self Expanding Metal Stents (SEMS) has been increasingly used for the palliative treatment of obstructing gastrointestinal tumors. This is the case of a 74-year-old man with an adenocarcinoma of the rectum, T4 N+ M+, that was admitted to our surgical department with sub-occlusion and rectal bleeding. Under endoscopic-fluoroscopic control, a SEMS was delivered with no complications and the patient was discharged the day after. He was scheduled for a palliative chemotherapy. Endoscopic stent introduction is a safe palliative procedure performed to improve the quality of life of patients with inoperable tumors of the rectum.