Post written by Todd H. Baron, MD, MASGE, from the Division of Gastroenterology and Hepatology, Director of Advanced Therapeutic Endoscopy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

This is a patient who had terminal cancer and sigmoid colonic obstruction not adequately relieved by overlapping, well-positioned, self-expandable metal luminal stents. Because he was a poor operative candidate for diverting colostomy, we performed a percutaneous endoscopic colostomy using a lumen-apposing stent (LAMS).  

This is a first-in-man report of such use of a lumen-apposing metal stent, which has potential implications for the future as being an alternative to surgical colostomy in selected patients.

Technically successful placement of commercially available self-expandable metal luminal stents does not ensure palliation of malignant colonic obstruction as some fail to adequately expand. Endoscopic percutaneous colostomy may be an available option in the future, but LAMS longer than what are currently available will be needed.  

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