Placement of a triple‐layered covered versus uncovered metallic stent for palliation of malignant gastric outlet obstruction: A multicenter randomized trial

Abstract

There was no statistically significant difference in stent patency, but use of a triple-layered covered SEMS was associated with less frequent stent dysfunction more than 4 weeks after stenting, despite similar short-term outcomes.

Partially-covered stent placement versus surgical gastrojejunostomy for the palliation of malignant gastroduodenal obstruction secondary to pancreatic cancer

“…The reason for this difference in the results is that our patients received a partially covered SEMS, which is advantageous over bare SEMSs given their resistance to tumor ingrowth and acceptable stent migration rates (2.0-13.6%) [21][22][23]. The rate of stent malfunction (16.0%) in our present study was much lower compared to those (28.5-43.0%) previously reported [6][7][8][9], but was within the range of values (7.9-28.0%) reported for partially covered SEMSs [22][23][24], and similar to the rate (18.1%) reported by Kim et al [17] for their prospective cohort of patients who also received the dual-design partially covered SEMS. Collectively, these results indicate that partially covered SEMS placement may provide durable palliation equivalent to surgical GJ.…”

“…Collectively, these results indicate that partially covered SEMS placement may provide durable palliation equivalent to surgical GJ. As partially covered SEMSs are being increasingly used, it is becoming evident that these devices may be more susceptible to stent collapse, an uncommon and often delayed cause of stent malfunction compared to bare SEMSs (1.7-10.3% vs. 0-3.2%) [21,24,25]. The underlying mechanism leading to stent collapse is unknown; however, it has been shown to occur more frequently in patients with gastric cancer than in those with pancreatic cancer (10.9% vs. 1.7%) [26]; the rate of stent collapse in our present pancreatic cancer patient cohort was only 1.3%.…”

Efficacy and safety of a partially covered duodenal stent for malignant gastroduodenal obstruction: a pilot study

“…Clinical success was defined as the relief of obstructive symptoms and/or at least 1 grade of improvement of the GOOSS score 3 days after stent placement. 12 Stent failure was defined as stent migration or repeat stenosis because of tumor ingrowth and/or overgrowth. Time to recurrence of obstruction, hospital stay after stent placement, 8-week stent patency rate, total stent patency, survival after stent placement, follow-up period, and adverse events were recorded.…”

Recent advancements in stent therapy in patients with malignant gastroduodenal outlet obstruction

“…Multivariate analysis revealed that the presence of a stent bridging the duodenal papilla [odds ratio (OR) =18.48; 95% CI, 2.298-148.48; P=0.006] was an independent predictor of acute pancreatitis. Table 2 shows the results of comparisons between CMS and UCMS in a prospective study and four randomized controlled trials (23)(24)(25)(26)(27). The technical and clinical success rates were similar between CMS and UCMS in all of these reports.…”