Comment on "Endoscopic stenting and diverting colostomy as a bridge to surgery for malignant colorectal obstruction": Balance between evidence-based medicine and personalized therapy

The better results obtained after SEMS placement and diverting colostomy as a bridge to surgery in comparison to early resection might derive from the possibility to improve the general status of the patient, who in general comes to the emergency room in poor conditions, having symptoms for several weeks with significant weight loss, de hydratation, electrolyte un balance and worsening of possible pre existing pulmonary, renal and cardiologic problems. Thus, performing early segmental resection (associated with a proximal diverting stoma to be closed under local anesthesia few days later) for sigmoid obstructing cancers 2- 3 days from admission (improving the general status of the patient) may be valid choice in selected patients.