Clinical Outcomes and Patency of Self-expanding Metal Stents in Patients with Malignant Upper Gastrointestinal Obstruction

Abstract

This study was performed to evaluate clinical outcomes and factors associated with patency of self-expanding metal stents (SEMS) in patients with malignant upper gastrointestinal (UGI) obstruction. In 83 patients with malignant UGI obstruction, 118 SEMS placements were performed. Obstruction sites were esophagus/gastro-esophageal junction (GEJ) and gastric outlet (GO) in 41 and 42 patients, respectively. Technical success was achieved in 99.2% and clinical success in 90.5%, with no procedure-related complications. Re-obstruction and migration occurred in 38.1% during a mean follow-up of 137 days; both occurred significantly more often with GO than esophageal/GEJ obstruction (49.2% vs 23.9%). Patency rates of esophageal/GEJ obstruction were 93.5, 78.1 and 67.0% at 30, 90 and 180 days, respectively, and were significantly higher than those of GO obstruction-71.7, 51.8 and 32.5%. Palliative chemotherapy or radiation therapy was not associated with stent patency. Endoscopic SEMS placement is a safe and effective palliative treatment for malignant UGI obstruction, and complications or stent patency differed according to obstruction site.

Clinical outcomes of re-stenting in patients with stent malfunction in malignant gastric outlet obstruction

“…These results were comparable with previous studies that had technical success rates of [8][9][10][11][12]. In this study, the perfect outcome regarding technical success for salvage SEMS placement might be influenced by SEMS that could guide the direction of stricture and relax the angulation of the pyloric area [13].…”

Self-expandable metallic stent placement for malignant obstruction in patients with locally recurrent gastric cancer

“…In our study, complications in the total gastrectomy group and the subtotal gastrectomy group (Billroth I and II) occurred at similar levels. The high level of complications in this study might be due to Cumulative stent patency and patient survival did not differ between the types of stent relatively long survival (median = 21.3 weeks), similar to results of a previous study in which complications occurred in 44% of patients with a median survival of 112 days [25].…”

Clinical Outcomes of Self-Expandable Metal Stent and Prognostic Factors for Stent Patency in Gastric Outlet Obstruction Caused by Gastric Cancer

“…There have been a few reports on the potential prognostic factors, such as the duration of oral intake, stent patency, or complications of the stent, in patients with a malignant gastroduodenal obstruction [8][9][10]. However, there are limited data, and the conclusions about the prognostic factors for stent patency are inconsistent [8][9][10].…”

“…However, there are limited data, and the conclusions about the prognostic factors for stent patency are inconsistent [8][9][10]. Chemotherapy after stent placement is a significant prognostic factor for oral intake and stent patency in some reports [8,9].…”

“…On the other hand, none of these factors including palliative therapy were prognostic for the complications of stents. These reports included patients with heterogeneous cancers [10], and there are no reports on the prognostic factors for stent patency in patients with primary gastric cancer.…”