COLONIC stenting for obstructing colorectal cancer can be performed with acceptable radiation exposure while offering patients a strong chance of avoiding stoma formation, according to new findings. The study assessed radiation dose, safety outcomes, and long-term patency in patients undergoing self-expanding metal stent (SEMS) placement as either palliation or a bridge to surgery.
The retrospective review examined procedures carried out between 2016 and 2021 at a single hospital, focusing on fluoroscopy time and radiation exposure measured through the kerma-area product. A total of 52 procedures in 47 patients were analyzed. Median radiation exposure was 1,373.7 µGy*m² and the median fluoroscopy time was 8.9 minutes. These values were found to fall within established diagnostic reference levels for comparable fluoroscopy-guided interventions, underscoring the relative safety of the procedure from a radiation standpoint.
Technical and clinical success was achieved in nearly nine out of ten cases. Among patients undergoing stenting for palliation, 88.9% maintained stent patency until the end of life. In patients treated as a bridge to surgery, laparoscopic resection was achieved in 70% of cases, demonstrating the utility of stenting in facilitating minimally invasive surgical approaches.
Complications were relatively uncommon. Perforation occurred in 5.8% of procedures, while stent migration was reported in 3.9%. Importantly, the overall outcomes supported the use of SEMS in both curative and palliative settings, with radiation exposure remaining comparable to or lower than other common interventional procedures.
The authors note that these data provide further evidence supporting the safe incorporation of colonic stenting into treatment protocols for obstructing colorectal cancer. In addition, the findings may justify the inclusion of colonic stenting in future national diagnostic reference levels to guide clinical standards and maintain safety benchmarks.
Reference: Smith CR et al. Colonic stenting for colorectal cancer: stoma avoidance with acceptable radiation exposure. Clin Endosc. 2025;58(5):738-743.
