Metallic self-expanding stent application in the upper gastrointestinal tract: caveats and concerns

Kozarek, Richard A.; Ball, Terrance J.; Patterson, David J.

doi:10.1016/s0016-5107(92)70321-6

Cited by 165 publications

(38 citation statements)

References 12 publications

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“…1, 2), the 12-french compression and delivery system proved far from Expandable metallic prostheses were initially placed ideal [5]. Moreover, the relatively large space between the metal struts allowed early ingrowth and recurrence of transhepatically for malignant biliary strictures by interventional radiologists [1].…”

Section: Stenoses Expandable Gastrointestinal Prostheses Havementioning

confidence: 99%

Complications and Lessons Learned from 10 Years of Expandable Gastrointestinal Prostheses

Kozarek

1999

Dig Dis

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Initially inserted percutaneously for malignant biliary stenoses, expandable gastrointestinal prostheses have evolved as primary treatment for malignant dysphagia and as an alternative to plastic prostheses for some types of obstructive jaundice. They are also in their infancy as a means to palliate unresectable obstructions of the gastric outlet, small bowel, and colorectum. Despite a decade of development, problems persist and include: maldeployment; inadequate expansion; ingrowth; overgrowth; erosion, and migration. This article outlines some of the problems noted and opportunities to improve this still-evolving technology.

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Section: Stenoses Expandable Gastrointestinal Prostheses Havementioning

confidence: 99%

Complications and Lessons Learned from 10 Years of Expandable Gastrointestinal Prostheses

Kozarek

1999

Dig Dis

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“…Chemotherapy, radiotherapy, laser therapy, and stent insertion have been reported to relieve symptoms. Recently, metallic stents have become popular in the palliative treatment of patients with dysphagia caused by oesophageal carcinoma (Song et al, 1991;Bethge et al, 1992;Fleischer et al, 1992;Kozarek et al, 1992;Schaer et al, 1992;Knyrim et al, 1993;May et al, 1995;Wengrower et al, 1998). These stents can be inserted on an outpatient basis and provide rapid relief of symptoms of dysphagia.…”

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confidence: 99%

Definitive chemoradiotherapy for patients with malignant stricture due to T3 or T4 squamous cell carcinoma of the oesophagus

et al. 2003

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We retrospectively investigated the efficacy and feasibility of concurrent chemoradiotherapy for patients with severe dysphagia caused by oesophageal squamous cell carcinoma. Concurrent chemoradiotherapy was performed in 57 patients with T3 or T4 disease containing M1 lymph node (LYM) disease. Chemotherapy consisted of protracted infusion of 5-fluorouracil (5-FU) 400 mg m À2 24 h À1 on days 1 -5 and 8 -12, combined with 2-h infusion of cisplatin (CDDP) 40 mg m À2 on days 1 and 8. Radiation treatment at a dose of 30 Gy in 15 fractions of the mediastinum was administered concomitantly with chemotherapy. A course schedule with 3-week treatment and a 1 to 2-week break was applied twice, with a total radiation dose of 60 Gy, followed by two or more courses of 5-FU and CDDP. In all, 24 patients (42%) achieved a complete response, and the 3-year survival rate was 19%. Major toxicities were leukocytopenia and oesophagitis, and there were two (4%) treatment-related deaths. In contrast, 22 patients with T3 disease survived longer than 35 patients with T4 disease (P ¼ 0.001); however, the survival rate in 15 patients with M1 LYM disease did not differ significantly from that in 42 patients without M1 LYM disease (P ¼ 0.3545). Our results indicate that definitive chemoradiotherapy is potentially curative for locally advanced oesophageal carcinoma with malignant stricture. The efficacy and survival of patients treated with this regimen are related to the T factor.

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“…Previously, surgical bypass surgery was performed in these patients [5,6]. However, since Kozarek et al reported the usefulness of duodenal stenting in 1922, EDuS has generally been conducted to alleviate the symptoms of duodenal stenosis associated with malignant diseases [11]. Studies comparing endoscopic stenting and surgical bypass have reported that although there were no obvious differences in efficacy and overall survival, the time until the resumption of oral ingestion was earlier and the duration of hospitalization was shorter in patients who underwent endoscopic stenting [7,12].…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of endoscopic duodenal stenting for the management of patients with unresectable pancreatic cancer

Niina¹,

Ito²,

Ueda³

et al. 2017

Gastroenterol Hepatol Endosc

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Metallic self-expanding stent application in the upper gastrointestinal tract: caveats and concerns

Cited by 165 publications

References 12 publications

Complications and Lessons Learned from 10 Years of Expandable Gastrointestinal Prostheses

Complications and Lessons Learned from 10 Years of Expandable Gastrointestinal Prostheses

Definitive chemoradiotherapy for patients with malignant stricture due to T3 or T4 squamous cell carcinoma of the oesophagus

Effectiveness of endoscopic duodenal stenting for the management of patients with unresectable pancreatic cancer

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