Beyond the Block: A Comprehensive Review of Colon Stenting in Obstructive Colorectal Cancer – A New Era of Management

A BSTRACT Colonic stenting has emerged as an effective approach for managing malignant large bowel obstruction, especially in elderly and high-risk patients traditionally treated with emergency surgery that carries significant morbidity and mortality. The use of self-expandable metallic stents allows rapid decompression of the obstructed colon, providing a bridge to elective surgery or serving as a palliative option for unresectable tumors. Technical success rates in malignant cases range from 78% to 99%, with clinical success between 70% and 99%, accompanied by low rates of complications such as migration (1.8% to 10%) and perforation (under 6%). Colon stenting offers clear benefits in perioperative outcomes and short-term quality of life (QoL), with survival comparable to surgical treatment. However, outcomes in benign indications are less favorable, marked by higher complication rates and variable clinical success, suggesting cautious use in these cases. Advances in stent technology, including drug-eluting and biodegradable designs, hold promise for enhancing efficacy and safety in future applications. Overall, colonic stenting represents a reliable and less invasive alternative to surgery in malignant colonic obstruction, improving patient recovery and QoL without compromising survival.