Self-expanding metal stents are useful to avoid a colostomy in selected patients with incurable rectal cancer and a limited life expectancy. The median technical and clinical success rates are 90-100% and 84-94%. A considerable number of patients will require surgical palliation because of failure of stent treatment (stent migration, pain, incontinence, fistu-lae, reobstruction) and in cases of low rectal cancer, patients might suffer tenesmus [90, 91]. In these cases and when the predominant symptom is rectal bleeding, endoscopic Nd-Yag Laser ablation is particularly indicated. Other indications for laser therapy are rectal obstruction and mucous discharge. It is feasible and has low complication rates; it requires repeated sessions .
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