Metal Stents for the Palliation of Inoperable Upper Gastrointestinal Stenoses

Bethge, N

doi:10.1016/s0002-9270(98)00059-8

Cited by 14 publications

(19 citation statements)

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“…Tumor ingrowth occurred in 14 (26.4%) patients at a mean of 78.4 d in our study. Overall recurrent stenosis rates of 8%-46% at an interval of 2-21 wk (mean, 7.5 wk) have been reported in other studies [14,15,[19][20][21][22][23][24] . It is difficult to compare our results with results of other studies because other reports included patients with a variety of cancers.…”

Section: Discussionsupporting

confidence: 65%

Self-expandable metallic stents for palliation of patients with malignant gastric outlet obstruction caused by stomach cancer

Kim

Kang²,

Kim³

et al. 2007

WJG

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Section: Discussionsupporting

confidence: 65%

Self-expandable metallic stents for palliation of patients with malignant gastric outlet obstruction caused by stomach cancer

Kim

Kang²,

Kim³

et al. 2007

WJG

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“…Remarkably, 13% (80/606) patients in this review were treated with a covered esophageal stent placed in the distal stomach/proximal jejunum. A clear drawback of uncovered stents in the duodenum is the occurrence of hyperplastic tissue or tumor growth through the mesh of the stent [15][16][17]. In the present study, we only used uncovered stents, whereas a second uncovered stent for tissue or tumor ingrowth was performed for six occluded stents in five patients.…”

Section: Discussionmentioning

confidence: 96%

Use of a colonoscope for distal duodenal stent placement in patients with malignant obstruction

et al. 2008

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Background Stent placement in the distal duodenum or proximal jejunum with a therapeutic gastroscope can be difficult, because of the reach of the endoscope, loop formation in the stomach, and flexibility of the gastroscope. The use of a colonoscope may overcome these problems. Objective To report our experience with distal duodenal stent placement in 16 patients using a colonoscope. Methods Multicenter, retrospective series of patients with a malignant obstruction at the level of the distal duodenum and proximal jejunum and treated by stent placement using a colonoscope. Main outcome measurements are technical success, ability to eat, complications, and survival. Results Stent placement was technically feasible in 93% (15/16) of patients. Food intake improved from a median gastric outlet obstruction scoring system (GOOSS) score of 1 (no oral intake) to 3 (soft solids) (p = 0.001). Severe complications were not observed. One patient had persistent obstructive symptoms presumably due to motility problems.Recurrent obstructive symptoms were caused by tissue/ tumor ingrowth through the stent mesh [n = 6 (38%)] and stent occlusion by debris [n = 1 (6%)]. Reinterventions included additional stent placement [n = 5 (31%)], gastrojejunostomy [n = 2 (12%)], and endoscopic stent cleansing [n = 1 (6%)]. Median survival was 153 days. Conclusion Duodenal stent placement can effectively and safely be performed using a colonoscope in patients with an obstruction at the level of the distal duodenum or proximal jejunum. A colonoscope has the advantage that it is long enough and offers good endoscopic stiffness, which avoids looping in the stomach.

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“…However, there is limited recurrence of obstructive symptoms resulting from tumour ingrowth, stent migration and tumour overgrowth. Restenosis by tumour ingrowth is the most common problem of uncovered stents [7,9,18]. Nassif et al [19] reported a 19.0% tumour ingrowth rate of …”

Section: Discussionmentioning

confidence: 99%

Palliative treatment of malignant gastroduodenal obstruction with metallic stent: prospective comparison of covered and uncovered stents

Lee

Choi

Shin

et al. 2009

Scandinavian Journal of Gastroenterology

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Background. The placement of self-expandable metallic stents (SEMS) is known to be effective palliative treatment of malignant gastroduodenal obstruction. There are two types of SEMS Á covered and uncovered Á each with its own advantages and disadvantages. This study was conducted to compare between the clinical outcomes of covered and uncovered stents in patients with malignant gastroduodenal obstruction. Patients and methods. The study was conducted prospectively from January 1998 to June 2007 and 154 patients were included. All had symptomatic gastroduodenal obstruction and were not candidates for curative operation. Seventy patients received covered SEMS, while the other 84 received uncovered SEMS. We compared technical and clinical success rates, tumour ingrowth rate, stent migration rate, stent patency time and patient survival in both SEMS groups. Results. The technical and clinical success rates of the covered and uncovered stent groups did not differ. Stent migration was more frequent in the covered stent group than in the uncovered group (17.1% versus 0%; p00.0001). Tumour ingrowth was more frequent in the uncovered stent group than in the covered group (16.6% versus 2.9%; p00.0066). Stent re-intervention rate, stent patency time and patient survival did not differ between groups. Conclusion. Covered and uncovered stent insertions are technically feasible and effective palliative treatment of malignant gastroduodenal obstruction. Covered stents can reduce the risk of tumour ingrowth, whereas uncovered stents are effective in preventing stent migration. However, covered stents did not differ from uncovered stents in regard to other clinical outcomes.

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Metal Stents for the Palliation of Inoperable Upper Gastrointestinal Stenoses

Cited by 14 publications

References 0 publications

Self-expandable metallic stents for palliation of patients with malignant gastric outlet obstruction caused by stomach cancer

Self-expandable metallic stents for palliation of patients with malignant gastric outlet obstruction caused by stomach cancer

Use of a colonoscope for distal duodenal stent placement in patients with malignant obstruction

Palliative treatment of malignant gastroduodenal obstruction with metallic stent: prospective comparison of covered and uncovered stents

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