Clin Colon Rectal Surg 2021; 34(04): 262-268
DOI: 10.1055/s-0041-1725947
Review Article

Endoscopic Management of Bowel Obstruction

David E. Beck
1   Department of Surgery, Colon and Rectal Surgery, Vanderbilt University, Nashville, Tennessee
› Author Affiliations


The traditional morbidity and mortality associated with traditional management has stimulated exploration of endoscopic approaches. Success depends on patient selection, the location and etiology of obstruction, patient status, and the capability of the endoscopist. This article discusses techniques of intralumenal dilation and stent placement and results from systematic reviews.

Publication History

Article published online:
15 April 2021

© 2021. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

  • References

  • 1 Lemberg B, Vargo JJ. Balloon dilation of colonic strictures. Am J Gastroenterol 2007; 102 (10) 2123-2125
  • 2 Beck DE. Use of stents for colonic obstruction. In: Cameron JL, Cameron AM. eds. Current Surgical Therapy. 10th ed.. Philedephia, PA: Elsevier; 2011: 157-160
  • 3 Deans GT, Krukowski ZH, Irwin ST. Malignant obstruction of the left colon. Br J Surg 1994; 81 (09) 1270-1276
  • 4 Gandrup P, Lund L, Balslev I. Surgical treatment of acute malignant large bowel obstruction. Eur J Surg 1992; 158 (08) 427-430
  • 5 Bonin EA, Baron TH. Update on the indications and use of colonic stents. Curr Gastroenterol Rep 2010; 12 (05) 374-382
  • 6 Baron TH. Enteral stents for the management of malignant colorectal obstruction. Accessed March 9, 2015 at:
  • 7 Boyle DJ, Thorn C, Saini A. et al. Predictive factors for successful colonic stenting in acute large-bowel obstruction: a 15-year cohort analysis. Dis Colon Rectum 2015; 58 (03) 358-362
  • 8 Tejero E, Mainar A, Fernández L, Tobío R, De Gregorio MA. New procedure for the treatment of colorectal neoplastic obstructions. Dis Colon Rectum 1994; 37 (11) 1158-1159
  • 9 Sebastian S, Johnston S, Geoghegan T, Torreggiani W, Buckley M. Pooled analysis of the efficacy and safety of self-expanding metal stenting in malignant colorectal obstruction. Am J Gastroenterol 2004; 99 (10) 2051-2057
  • 10 Watt AM, Faragher IG, Griffin TT, Rieger NA, Maddern GJ. Self-expanding metallic stents for relieving malignant colorectal obstruction: a systematic review. Ann Surg 2007; 246 (01) 24-30
  • 11 Knight AL, Trompetas V, Saunders MP, Anderson HJ. Does stenting of left-sided colorectal cancer as a “bridge to surgery” adversely affect oncological outcomes? A comparison with non-obstructing elective left-sided colonic resections. Int J Colorectal Dis 2012; 27 (11) 1509-1514
  • 12 Sabbagh C, Browet F, Diouf M. et al. Is stenting as “a bridge to surgery” an oncologically safe strategy for the management of acute, left-sided, malignant, colonic obstruction? A comparative study with a propensity score analysis. Ann Surg 2013; 258 (01) 107-115
  • 13 van Hooft JE, van Halsema EE, Vanbiervliet G. et al; European Society of Gastrointestinal Endoscopy (ESGE). Self-expandable metal stents for obstructing colonic and extracolonic cancer: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Gastrointest Endosc 2014; 80 (05) 747-61.e1 , 75
  • 14 Arezzo A, Passera R, Lo Secco G. et al. Stent as bridge to surgery for left-sided malignant colonic obstruction reduces adverse events and stoma rate compared with emergency surgery: results of a systematic review and meta-analysis of randomized controlled trials. Gastrointest Endosc 2017; 86 (03) 416-426
  • 15 Sagar J. Colorectal stents for the management of malignant colonic obstructions. Cochrane Database Syst Rev 2011; (11) CD007378
  • 16 Matsuda A, Miyashita M, Matsumoto S. et al. Comparison of long-term outcomes of colonic stent as “bridge to surgery” and emergency surgery for malignant large-bowel obstruction: a meta-analysis. Ann Surg Oncol 2015; 22 (02) 497-504
  • 17 Yang SY, Park YY, Han YD. et al. Oncologic outcomes of self-expandable metallic stent as a bridge to surgery and safety and feasibility of minimally invasive surgery for acute malignant colonic obstruction. Ann Surg Oncol 2019; 26 (09) 2787-2796
  • 18 Aston NO, Owen WJ, Irving JD. Endoscopic balloon dilatation of colonic anastomotic strictures. Br J Surg 1989; 76 (08) 780-782
  • 19 Park CH, Yoon JY, Park SJ. et al. Clinical efficacy of endoscopic treatment for benign colorectal stricture: balloon dilatation versus stenting. Gut Liver 2015; 9 (01) 73-79
  • 20 Small AJ, Young-Fadok TM, Baron TH. Expandable metal stent placement for benign colorectal obstruction: outcomes for 23 cases. Surg Endosc 2008; 22 (02) 454-462