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

Kim, Tae Oh; Kang, Dae Hwan; Kim, Gwang Ha; Heo, Jeong; Song, Geun Am; Cho, Mong; Kim, Dong Heon; Sim, Minyoung

doi:10.3748/wjg.v13.i6.916

Cited by 32 publications

(24 citation statements)

References 26 publications

(32 reference statements)

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“…Pancreatic cancer is usually the most common cause, and the duodenum is a common main site of an obstruction. A few reports on these stents dealt exclusively with gastric cancer [6,7,16]. Our study included only patients with a malignant gastric outlet obstruction caused by primary gastric cancer, and patients with other malignancies or recurrent cancer of the anastomosis site were excluded.…”

Section: Discussionmentioning

confidence: 99%

“…Many reports on the use of a SEMS for a malignant gastroduodenal obstruction included heterogeneous patient groups with different cancers such as pancreaticobiliary cancer, duodenal cancer, and gastric cancer. Some studies have reported on the endoscopic use of a SEMS for malignant gastric outlet obstructions caused by primary gastric cancer [6,7]. The biological activity and response to chemotherapy or radiotherapy can differ according to the type of cancer, which might affect the stent patency and clinical outcome.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2009

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The aim of this study was to assess clinical outcomes of endoscopic stenting for a gastric outlet obstruction caused by gastric cancer and the prognostic factors for stent patency by reviewing medical records. Eighty-one stents were inserted into 75 patients (48 men, average age 66 years). The technical and clinical success rates were 98 and 87%, respectively. The median stent patency was 55 days (95% CI 40-70 days). The median survival was 79 days (95% CI 58-123 days). Stent reobstruction caused by tumor ingrowth or overgrowth occurred in 25 cases (31%). Cox multivariate regression analysis showed that covered stents (odds ratio 0.29, 95% CI 0.11-0.76; P = 0.01) and chemotherapy after stent placement (odds ratio 0.34, 95% CI 0.13-0.91; P = 0.03) were significant prognostic factors for stent patency. This study found that endoscopic stenting is a safe and effective palliation treatment for malignant gastric outlet obstruction and a covered stent and chemotherapy are significant prognostic factors for stent patency.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2009

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“…In the study by Kim et al [10] , restenosis occurring at less than 4 wk after stent placement was found in 5/43 patients (11.6%), which was successfully treated with placement of covered stents in the new stenotic area. Stentrelated problems requiring treatment occurred in 17 patients (32.1%) during the followup period (mean 145 d, range 4718 d).…”

Section: Complicationsmentioning

confidence: 95%

“…nausea, vomiting, abdominal distention, and reflux), which occurred in 29/32 patients (90.6%), with no symptomatic improvement in three patients. Kim et al [10] also used symptomatic improvement as the measure of clinical success in their assessment of outcomes after SEMS placement in 53 patients with gastric outlet obstruction due solely to gastric cancer, in which they reported a success rate of 81.8%.…”

Section: Efficacy and Outcomesmentioning

confidence: 99%

Treatment of malignant gastric outlet obstruction with endoscopically placed self-expandable metal stents

Gaidos

Draganov²

2009

WJG

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Malignant gastroduodenal obstruction can occur in up to 20% of patients with primary pancreatic, gastric or duodenal carcinomas. Presenting symptoms include nausea, vomiting, abdominal distention, pain and decreased oral intake which can lead to dehydration, malnutrition, and poor quality of life. Endoscopic stent placement has become the primary therapeutic modality because it is safe, minimally invasive, and a cost-effective option for palliation. Stents can be successfully deployed in the majority of patients. Stent placement appears to lead to a shorter time to symptomatic improvement, shorter time to resumption of an oral diet, and shorter hospital stays as compared with surgical options. Recurrence of the obstructive symptoms resulting from stent occlusion, due to tumor ingrowth or overgrowth, can be successfully treated with repeat endoscopic stent placement in the majority of the cases. Both endoscopic stenting and surgical bypass are considered palliative treatments and, to date, no improvement in survival with either modality has been demonstrated. A tailored therapeutic approach, taking into consideration patient preferences and involving a multidisciplinary team including the therapeutic endoscopist, surgeon, medical oncologist, radiation therapist, and interventional radiologist, should be considered in all cases.

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“…The median duration of stent patency in the upper GI tract are reported around 55 to 307 days in most studies and are not significantly different between covered and uncovered types or among products from various companies, except for the esophageal cancer. In pyloric obstruction, the reported patency rates were 71% at 4 weeks, 61% at 8 weeks, and 33% at 6 months, and in cardiac obstruction including esophageal cancer, the rates were 94% at 4 weeks, 78% at 3 months, and 67% at 6 months in previous studies 1,4,20,21. When comparing stents with surgical bypass in malignant upper GI obstruction, stent showed many advantages in terms of less invasiveness and complications, shorter hospital stay, and lower cost 22-25.…”

Section: Clinical Outcomes Of Stents In the Upper Gi Tractmentioning

confidence: 80%

Upper Gastrointestinal Stent

Kim

Yang

2012

Clin Endosc

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Gastrointestinal (GI) stent has been developed for palliation of obstructive symptoms in various diseases causing obstruction of GI tract. Self-expanding metal stent (SEMS) has replaced old type of plastic stent, and endoscopic insertion of stent has replaced fluoroscopy-guided insertion. Nowadays, newly-designed SEMSs have been developed for prevention of complications such as stent migration and re-obstruction, and indications of stent recently have been widened into benign conditions as well as malignant obstruction. In this review, the types, method of insertion, indications and clinical outcomes of stent in the upper GI tract would be discussed.

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

Abstract: AIM:To ascertain clinical outcome and complications o f s e l f-e x p a n d a b l e m e t a l s t e n t s fo r e n d o s c o p i c palliation of patients with malignant obstruction of the gastrointestinal (GI) tract.

Cited by 32 publications

References 26 publications

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

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

Treatment of malignant gastric outlet obstruction with endoscopically placed self-expandable metal stents

Upper Gastrointestinal Stent

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