Obstructing cancer of the gastric antrum: palliative treatment with covered metallic stents.

Abstract

A new technique, which requires a simple surgical gastrostomy without general anesthesia, is described for placement of covered expandable metallic stents. This technique was performed successfully in a patient with malignant obstruction of the gastric antrum, obviating palliative surgical resection.

Metallic stenting of gastroduodenal and colonic stenoses

“…In 1992 and 1993 four case reports [8][9][10][11] of successful stenting of malignant gastroduodenal outlet obstruction were published. Two of them implanted the stent through a gastrostomy [8,9].…”

“…Two of them implanted the stent through a gastrostomy [8,9]. Feretis et al [7] described stenting as an effective palliation of malignant gastric outlet obstruction in 12 patients.…”

Leakage of Jejunal End of Roux Limb after Total Gastrectomy: Management with a Placement of a Covered Metallic Stent: Case Report

“…Surgical palliation is indicated in selected cases with peritonitis and paralytic ileus, but because of the invasiveness of the intervention and the poor general condition of these patients, it is associated with significant complications. Although there was no report for postoperative leakage after gastric surgery, metallic stent placement has shown encouraging results for the palliation of malignant gastrointestinal tract obstruction and fistula (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13). In this report, we present a case of the postoperative leakage after total gastrectomy which was successfully treated with temporary placement of a covered metallic stent.…”

Malignant Gastric Outlet Obstructions: Treatment with Self-Expandable Metallic Stents

“…19 Different types of covering materials have been utilized to cover expandable metallic stents, including polyurethane, silicone rubber, and nylon. 2,6,16,20,21 Disruption of the covering membrane may lead to tumor ingrowth, 20 with polyurethane membranes in the gastroduodenal area being particularly susceptible to chemical degradation after exposure to acidic gastric fluid, bile salts, and certain hydrolytic enzymes in pancreatic secretions.…”

“…21,36,37 Stent migration is related to chemotherapy after stent placement (Fig. 2), but not to balloon dilation before or after stent placement.…”