Self-expandable metal stents (SEMS) can be used to relieve benign and malignant colonic obstruction. Data for the use of SEMS in benign disease are largely limited to preoperative use to allow decompression of acute obstruction. Long-term use of uncovered SEMS for benign disease is limited because of their nonremovability and long-term complications. When covered SEMS are used for benign disease, the high migration rates are high and long-term resolution of the underlying disease is modest at best. SEMS are most useful for relief of malignant colonic obstruction - both preoperatively and palliatively. Although retrospective studies of surgery and SEMS for preoperative and palliative indications show comparable to superior results following SEMS placement, randomized trials have not shown as favorable results after SEMS placement. Outcomes following placement of colonic SEMS are dependent on both patient and operator factors. Although generally safe, serious complications may occur. This chapter reviews the outcomes following SEMS placement for benign and malignant disease.
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