Placement of Colonic Self-Expandable Metal Stents

Placement of Colonic Self-Expandable Metal Stents

Amy Hosmer, MD

The placement of self-expandable metal stent (SEMS) in the colon is performed for the palliation of malignant disease within or adjacent to the colon and for preoperative decompression. Placement of colonic SEMS for the treatment of benign disease is rarely indicated. Several FDA-approved colonic SEMS with varying deployment mechanisms and proprietary features are currently available; however, their functionality is largely similar. All currently available colonic SEMS are uncovered. Based on meta-analysis data, the overall technical and clinical success is well over 90%.1


  • 1. Colorectal cancer:

    • a. Palliation of advanced disease (partial obstruction or complete obstruction and no evidence of systemic toxicity)

    • b. Preoperative decompression/bridge to surgery3

  • 2. Extracolonic pelvic malignancies (i.e., ovarian cancer, sarcomas, etc.)


  • 1. Consider imaging with rectal contrast (i.e., barium enema, CT scan w/ rectal contrast) prior to stent placement to provide an anatomical roadmap.

  • 2. Cautious bowel preparation can be considered for patients with partial colonic obstruction, generally more proximally lesions.

    • a. For patients with subtotal or total colon obstruction, oral bowel preparations should be avoided and replaced with enema preparations to clean the colon distal to the obstruction.

  • 3. Obtain informed consent from the patient or patient representative that outlines the possible complications of the procedure as well as alternative methods of treatment.

  • 4. Start an intravenous line for administration of systemic sedation.

  • 5. Consider preprocedure antibiotics in patients with complete bowel obstruction as microperforations with bacterial translocation can occur with insufflation during the procedure.

May 29, 2020 | Posted by in GASTROENTEROLOGY | Comments Off on Placement of Colonic Self-Expandable Metal Stents
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