Endoscopic methods (other than stents) for palliation of rectal carcinoma

Patients with unresectable or metastatic rectal cancer may have symptoms of obstruction, bleeding, pain, or tenesmus. Insertion of a self-expandable metal stent is the most durable nonsurgical method for relieving obstruction and has been reviewed in the previous article. Other endoscopic methods of palliating obstruction have been largely replaced by expandable metal stent placement. However, laser ablation is still a useful therapy for some patients, particularly when the predominant symptom is rectal bleeding. The indications and results of endoscopic laser therapy along with other endoscopic treatments for the palliation of rectal cancer will be reviewed here. (C) 2004 The Society for Surgery of the Alimentary Tract.