How do doctors decide between surgery or stenting for a blocked bowel due to colon cancer?

Doctor's Answers 2

Photo of Dr Nan Yaw Wong
Dr Nan Yaw Wong

Colorectal Surgeon

As far as possible, surgery should be the first choice to deal with the problem.

Stenting is done when the patient is too weak to undergo surgery at the point of presentation. The patient may be dehydrated and have severe electrolyte imbalance due to the obstruction. In good hands, stenting produces good results, and allows both the patient and surgeon to buy time for proper stabilisation and work-up before definitive surgery. For this reason stenting is often called the "bridge to surgery".

Another option in obstructed cases is to create a temporary diversion colostomy to relieve the obstruction. This is often done in advanced cases where the tumour is so large and surgery becomes dangerous. The stoma relieves the obstruction, and the patient may be stabilised and then undergo chemo and/or radiotherapy to down-stage the tumour before surgery.

If a patient has obstructing colon cancer (blocked bowel), he/she will require surgery unless his/her health is so critical that surgery is contra-indicated (e.g. someone with life-threatening heart failure found to have blocked bowel). Stenting is performed to alleviate the blockage so that the patient's overall health can be improved prior to undergoing the surgery.

Stenting has been shown to improve the patient's surgery results and reduce complications if the cancer is in the left side of the colon. Blockage on the right side of the colon is best treated with surgery as stenting does not improve the result of surgery. The surgeon will also need to know how to perform the stenting or get an endoscopist who is experienced with stenting to do the procedure. Currently, the technique is widely practiced and available in almost all hospitals in Singapore.

Similar Questions

Could I have colon cancer if I have a history of piles and blood on passing motion?

Hi Piles is a very common condition and especially in modern society with our current life style. They don't normally cause difficulty blockage but the problems comes if you are constipated and the stools are hard. To improve on this, the general advise is ensure that you have adequate amount of fluids daily (>2L) and a good amount fruit and vegtables daily for the fibre. This will ensure you are regular and the stools are soft to prevent the straining and constipation that will agravate the piles. Laxative may help to keep the stools soft.

Photo of Dr Yuk Man Kan

Answered By

Dr Yuk Man Kan

General Surgeon

When should I see a doctor regarding rectum bleeding if I’m worried about colon cancer?

If you truly have reasons to worry about having colon cancer, please do not delay any longer. It is a well-known fact that survival is best when colon cancers are detected early. If you are 50yr and above or having a significant family history of colon cancer or you have a past history of colon polyps, you automatically fall into a higher risk group for having colon cancer. So many have made the mistake of assuming a benign cause of bleeding just because one has a past history of haemorrhoids. Such assumptions may result in unnecessary delay in making the right diagnosis.

Photo of Dr Wai Leong Quan

Answered By

Dr Wai Leong Quan

Gastroenterologist

Ask any health question for free

I’m not so sure about a procedure...

Ask Icon Ask a Question

Join Human

Sign up now for a free Human account to get answers from specialists in Singapore.

Sign Up

Get The Pill

Be healthier with our Bite-sized health news straight in your inbox