Colon stenting in acute colorectal obstruction caused by tumor. Literature review

Background. Colorectal cancer (CRC) remains a major global health concern both in Russia and worldwide. According to WHO data, CRC ranks as the third most common cancer and has a tendency to increase both morbidity and mortality. According to 2022 data, CRC is the fifth most common malignancy and the second leading cause of cancer death in Russia. Acute colorectal obstruction (ACRO) is one of the most frequent and threatening complications of CRC, necessitating urgent treatment. Colonic stenting is a modern minimally invasive alternative to emergency surgery for ACRO. However, a detailed analysis and systematization of the accumulated data are required to assess its efficacy and safety as well as the variability of long-term results and the risk of complications. Aim of the study: to conduct a systematic analysis of the data available in modern literature on efficacy, safety and long-term results of colonic stenting as a method of ACRO treatment in patients with CRC. Material and Methods. Scientific publications from PubMed, Scopus, Web of Science, eLibrary, CyberLeninka databases published over the last 10 years, as well as data from the World Health Organization (WHO) and specialized oncology portals on the topic of the study were analyzed. Results. The literature review demonstrated that colorectal stenting is an effective minimally invasive strategy for the ACRO treatment in CRC patients, allowing in some cases to avoid emergency surgery or to be used as a “bridge” to planned surgery. The technique has been found to be associated with a certain spectrum of complications arising both during surgery and in the postoperative period (e.g. perforation, stent migration, reobstruction). Significant variability in long-term outcomes was observed, highlighting the lack of uniformity and the need for further standardisation of indications and technique. Conclusion. Colorectal stenting is an important and effective method for the treatment of ACRO caused by CRC, offering significant advantages over emergency surgery for a certain category of patients. However, the presence of complications and the ambiguity of long-term outcomes require further study of this technique, improvement of patient selection criteria, technical aspects of stenting, and development of clear patient management algorithms to improve treatment outcomes.