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Invited Critique
Oct 2011

To Stent or Not to Stent: Comment on “Endoscopic Palliation of Patients With Incurable Malignant Colorectal Obstruction by Means of Self-expanding Metal Stent”

Author Affiliations

Author Affiliation: Department of Surgery, Johns Hopkins University, Baltimore, Maryland.

Arch Surg. 2011;146(10):1163. doi:10.1001/archsurg.2011.230

The premise of the article by Manes and colleagues1 is that self-expanding metal stents are a good palliative choice for patients with incurable colorectal cancer who develop colorectal obstruction. The optimal treatment of these patients is still being debated. The current treatment paradigm trend is to initiate systemic therapy for patients without localized symptoms associated with their cancer (obstruction, pain, or bleeding) before an operation.