Enteral Stents for Malignancy: A Report of 46 Consecutive Cases over 10 years, with Critical Review of Complications

Phillips, Melissa S.; Gosain, Sonia; Bonatti, Hugo; Friel, Charles M.; Ellen, Kristi; Northup, Patrick G.; Kahaleh, Michel

doi:10.1007/s11605-008-0598-4

Cited by 50 publications

(32 citation statements)

References 14 publications

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“…Looking at the long term results and complications of enteral stent placement for unresectable cancer, Phillips et al [21] reviewed the outcomes of 46 patients with malignant gastric outlet obstruction. All patients had successful stent placement and 42 patients (91%) showed clinical improvement.…”

Section: Complicationsmentioning

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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Section: Complicationsmentioning

confidence: 99%

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

Gaidos

Draganov²

2009

WJG

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“…37,38 However, SEMS can become obstructed or overgrown by tumor resulting in reduced luminal patency (57% in one study) after 6 months. 39 With the recent development of LAMS, Tyberg et al 40 examined the utility of LAMS for EUS-guided GJ (EUS-GJ) in patients with benign and malignant GOO. In an international, prospective trial of 26 patients with GOO, the authors demonstrated technical success of EUS-GJ using LAMS in 24 patients (92.3%).…”

Section: Other Procedures: Gastrojejunostomy Eus-directed Transgastrmentioning

confidence: 99%

Lumen apposing metal stents: A review of current uses and outcomes

Bank

Adler

2017

Int J Gastrointest Interv

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A B S T R A C TLumen-apposing metal stents (LAMS) represent a new innovation in gastrointestinal endoscopy. These devices have a saddle-shaped design and larger inner lumen diameter than either plastic or metal biliary stents, which should decrease the risk of migration and allows for an endoscope to pass into pancreatic fluid collections as well as the ability to perform direct endoscopic necrosectomy. LAMS were originally conceived and designed for transmural pancreatic fluid collection drainage but are currently also being used for many off label indications. There are three different LAMS available at this time around the globe. This manuscript will review the current state of the art with regards to LAMS and their indications, usage, and outcomes.

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“…Massive bleeding related to an aorto-enteric fistula has been reported in one case that was managed with placement of a stent-graft in the aorta. 42 …”

Section: Major Complications Bleedingmentioning

confidence: 99%

Enteral stents: Complications and their management

Lopera

Gregorio

Laborda

et al. 2016

Int J Gastrointest Interv

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The treatment of malignant colonic and gastric outlet obstruction with self-expanding metallic stents (SEMS) is an established technique that can be performed by radiologic or a combination of radiologic and endoscopic guidance. The procedure is very effective to relieve the obstructive symptoms of advanced malignancies, with important clinical benefits and significant improvement in quality of life for the patients. Despite much advancement in the designs of SEMS, enteral stent placement is still associated with some significant early and late complications. Stent dysfunction mainly caused by tumor ingrowth/over growth, and stent migration when covered stent are used, are relatively common complications and many times require reinterventions.

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Enteral Stents for Malignancy: A Report of 46 Consecutive Cases over 10 years, with Critical Review of Complications

Abstract: SEMS effectively palliate gastric outlet obstructions that result from upper gastrointestinal malignancies. Their benefits offset potential complications or malfunctions, when a pluridisciplinary approach is adopted.

Cited by 50 publications

References 14 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

Lumen apposing metal stents: A review of current uses and outcomes

Enteral stents: Complications and their management

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