Related Experiment Video
Updated: Jul 11, 2026

Surgical Trunk Oriented Laparoscopic Right Hemicolectomy (ST-LRH) for Right-Sided Colon Cancer
Published on: July 25, 2025
Colonic stent versus surgery for the management of acute malignant colonic obstruction: a decision analysis
A Siddiqui1, N Khandelwal, T Anthony
1Division of Gastroenterology, VA North Texas Health Care System and University of Texas Southwestern Medical School, Dallas, TX, USA. Ali.Siddiqui@UTSouthwestern.edu
Background:
Acute colonic obstruction because of advanced colonic malignancy is a surgical emergency.
Aim:
To compare the clinical outcomes and cost-effectiveness of endoscopic self-expanding metal stent (SEMS) vs. surgery for emergent management of acute malignant colonic obstruction in patients with metastatic colorectal cancer over a 6-month period.
Methods:
Decision analysis was used to calculate the cost-effectiveness and success of two competing strategies in a hypothetical patient with metastatic colon cancer presenting with acute, malignant colonic obstruction: (i) emergent colonic stent (SEMS cohort); (ii) emergent surgical resection followed by diversion (surgery cohort).
Results:
Self-expanding metal stent resulted in a success and a lower mortality rate when compared to surgery over a 6-month period. Colonic SEMS was also associated with a lower mean cost per patient (USD 27,225 vs. USD 57,398). Mortality in the surgery group was 25 times that of the SEMS cohort. One- and two-way sensitivity analyses identified SEMS as the dominant strategy.
Conclusion:
Colonic stent insertion is more effective and less costly than surgery for the management of colonic obstruction in patients with metastatic colon cancer.
Related Concept Videos
Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Peptic Ulcer Disease V: Surgical Management and Nursing Care
Surgical Interventions for Peptic Ulcer Disease
Endoscopic Procedures II: Colonoscopy
Appendicitis-II: Diagnostic Studies and Management
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...