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

Cho, Yu Kyung; Kim, Sang Woo; Hur, Won Haeng; Nam, Kwan Woo; Chang, Jae Hyuck; Park, Jae Myung; Lee, In Seok; Chung, In‐Sik

doi:10.1007/s10620-009-0787-3

Cited by 70 publications

(55 citation statements)

References 26 publications

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“…Kim et al [14] found that patients who received chemotherapy after stent placement were noted to have significantly prolonged stent patency. Cho et al [13] reported similar findings, however they included the use of covered stents, in addition to chemotherapy after stent placement, as a significant prognostic factor contributing to stent patency.…”

Section: Efficacy and Outcomesmentioning

confidence: 79%

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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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Section: Efficacy and Outcomesmentioning

confidence: 79%

“…Kim et al [14] and Cho et al [13] evaluated clinical factors that contribute to longer durations of stent patency. Kim et al [14] found that patients who received chemotherapy after stent placement were noted to have significantly prolonged stent patency.…”

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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“…Mansoor et al [39] described similar rates of stent-related complications, 14 %, including blockage and migration. Another study by Cho et al [40] found much higher re-obstruction rates at 31 %, with covered stents and chemotherapy after stent placement significant prognostic factors for stent patency.…”

Section: Emerging Technologiesmentioning

confidence: 95%

“…Gastro-duodenal stents have emerged as a safe and effective alternative to surgical therapy. Technical and clinical success rates have proven to be high at 89-98 % and 85.5-89 %, respectively [37][38][39][40]. However, the procedure is not without complications.…”

Section: Emerging Technologiesmentioning

confidence: 99%

Surgical and Endoscopic Options for Benign and Malignant Gastric Outlet Obstruction

Miller

Schwaitzberg

2014

Curr Surg Rep

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Gastric outlet obstruction (GOO) can be due to a variety of causes of both benign and malignant sources. As the etiology of GOO shifts from mostly benign to mostly malignant, treatment options have also evolved. Traditional options have only included surgery, but an increase in technology has seen the emergence of endoscopic alternatives. For benign disease, such as peptic ulcer disease, endoscopic balloon dilation has reduced the number of patients needing to undergo larger and more invasive surgical procedures. It has also proven successful in treating obstruction from stricture following bariatric surgery, but surgical revision or reversal remains the gold standard. Numerous surgical procedures have shown effectiveness when treating GOO, with new procedures constantly emerging. When malignancy is the cause, the procedural focus shifts from curative to palliative with the main focus being resumption of oral intake. Endoscopic stenting provides a viable alternative to gastro-jejunostomy, but due to problems with re-obstruction and stent migration, it should be reserved for patients with shorter life expectancies.

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“…One of the studies reported a lower clinical success rate of 75%, but was limited by inclusion of patients since 1991, when SEMS were not specifically designed for enteral deployment [52]. The two most recent studies included in this analysis reported technical success of greater than 98% and clinical efficacy of 86-90%, thereby highlighting the technical and device-related advances in endoscopic enteral stent placement [53,54]. Complications range from 11 to 43% and commonly occur in the form of stent migration or reocclusion.…”

Section: Enteral Stentingmentioning

confidence: 99%

Pancreatic cancer: an endoscopic perspective

Majumder

Chubineh

Birk

2012

Expert Review of Gastroenterology & Hepatology

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Pancreatic cancer continues to be a diagnostic and therapeutic challenge. The advent of endoscopic ultrasound-guided interventions have brought about a paradigm shift in the endoscopic approach to diagnosis, treatment and palliation of this common malignancy. The last decade has witnessed significant advances in techniques of endoscopic biliary drainage, endoluminal stenting, celiac plexus neurolysis and image-guided radiation therapy, which have transformed the scope of palliation in pancreatic cancer. Moreover, endoscopic ultrasound-aided intratumoral delivery of fiducials, radioisotopes and chemotherapeutic agents have shown promising results and warrant further investigation. This review summarizes the recent advances in endoscopic applications for the management of pancreatic neoplasms. Keywords: celiac plexus block • enteral stent • EUS • EUS-FNA • EUS-FNI • fiducial • pancreatic cancer • SEMSPancreatic cancer: an endoscopic perspective Expert Rev. Gastroenterol. Hepatol. 6(1), 95-104 (2012) Medscape: Continuing Medical Education OnlineThis activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Medscape, LLC and Expert Reviews Ltd. Medscape, LLC is accredited by the ACCME to provide continuing medical education for physicians.Medscape, LLC designates this Journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.All other clinicians completing this activity will be issued a certificate of participation. To participate in this journal CME activity: (1) review the learning objectives and author disclosures; (2) study the education content; (3) take the post-test with a 70% minimum passing score and complete the evaluation at www.medscape.org/journals/expertgastrohep; (4) view/print certificate. Release date: December 9, 2011; Expiration date: December 9, 2012 Learning objectives• Compare different imaging modalities in the diagnosis and staging of pancreatic cancer • Evaluate the use of EUS and endoscopic retrograde cholangiopancreatography in obtaining the tissue diagnosis of pancreatic cancer • Analyze the role of EUS in the treatment of pancreatic cancer • Assess how EUS may be used in palliative procedures for pancreatic cancer Worldwide, pancreatic cancer is the fourth leading cause of cancer-related death in men and the fifth leading cause in women, with an approximate incidence of ten per 100,000 population per year [1]. There has been no appreciable change in the epidemiology of this disease in the past few decades. With the USA recording more than 30,000 deaths in 2008, a number that is almost equal to reported incidence, pancreatic cancer continues to be a diagnostic and therapeutic challenge. The prognosis of pancreatic cancer is dismal, with postoperative 5-year survival rates varying from 3 to 25% [2,3]. Nearly two-thirds of patients w...

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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

Cited by 70 publications

References 26 publications

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

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

Surgical and Endoscopic Options for Benign and Malignant Gastric Outlet Obstruction

Pancreatic cancer: an endoscopic perspective

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