| [ Summary ] |
Coverage of stent (self‒expandable metallic stent ; SEMS) treatment for the colon and rectum finally became available in 2012 in Japan within the public health insurance system. In this chapter, I reviewed the literature relevant to the present conditions and the future prospects for this therapy. SEMS use is currently indicated in Japan in cases of malignant colorectal stenosis that include palliation and Bridge‒to‒Surgery (BTS). In BTS, the short duration of hospitalization and reduced postoperative complications, colostomy rate, and mortality rate are as expected as compared to emergency surgery. Although it has been reported that the complication rate is low, adequate preparation and informed consent are important because complications can still occur. There are some tips and points to be taken into consideration to achieve safe procedures. The Colonic Stent Safe Procedure Research Group, one of the subordinate organizations of the Japan Society for Gastrointestinal Endoscopy, has put together a set of mini-guidelines for use of the colon stent and has published them on the Society's website. Because the longterm prognosis for BTS placement of SEMS is unknown, the European Society of Gastrointestinal Endoscopy (ESGE) clinical guidelines do not currently recommended it as a standard treatment for obstructive colorectal cancers. A future large prospective study is needed to determine the safety and efficacy of this treatment. |