• M Morino, A Bertello, A Garbarini, G Rozzio, and A Repici.
• Department of Surgery, Chirurgia Generale IIa, University of Turin, C.so A.M. Dogliotti n degrees 14, 10126 Turin, Italy. mmorino@ddmc.unito.it
• Surg Endosc. 2002 Oct 1;16(10):1483-7.

BackgroundAcute left-side colonic obstruction is a surgical emergency whose management is controversial. Recently metallic expandable stents have been used to relieve obstruction either to palliate the condition or to prepare for an elective surgical resection.MethodsWe propose a new minimally invasive therapeutic strategy for the management of malignant colonic obstructions: emergency endoscopic stenting followed by elective laparoscopic one-stage resection. The first four cases are presented.ResultsThe stents were positioned successfully in all cases, and all the patients had an immediate restoration of bowel functions. After a period that varied from 4 to 5 days, they underwent a one-stage laparoscopic resection and were discharged 5 to 7 days after the operation. There were no postoperative complications.ConclusionsMalignant colonic obstruction can be managed by a sequential minimally invasive endolaparoscopic approach with an excellent postoperative outcome, good patient comfort, and a short hospital stay without the need for diverting stomas. A study involving a larger number of patients is needed to determine whether this approach is superior to traditional open surgery in terms of morbidity, mortality, quality of life, and recurrences.

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