Treatment options in obstructed left-sided colonic cancer

Abstract

Colorectal cancer presents as an emergency with large bowel obstruction in up to 29% of cases. These patients are often elderly with multiple co-morbidities and deranged physiological function. Traditionally, the mainstay of treatment was with staged surgical procedures, but recent trends have moved towards a primary resection and anastomosis. The use of self-expanding metallic stents has been described to alleviate obstruction and act as a bridge to surgery or as a definitive palliative procedure. Although there is no significant difference in long-term survival between these two treatment modalities, there is no consensus as to which approach is optimal in this group patients.