Predictors of stent dysfunction after self-expandable metal stent placement for malignant gastric outlet obstruction: tumor ingrowth in uncovered stents and migration of covered stents

Abstract

Both U-SEMS and C-SEMS are effective with comparable patencies. Tumor ingrowth and stent migration are the main causes of stent dysfunction for U-SEMS and C-SEMS, respectively. With regard to stent dysfunction, U-SEMS might be a good option for patients receiving chemotherapy, while C-SEMS with longer stents for patients in good condition. (Clinical trial registration number: UMIN000024059).

Palliative Surgery or Metallic Stent Positioning for Advanced Gastric Cancer: Differences in QOL

“…On the other hand, a gastrojejunostomy, even if it is a palliative operation, might give the feeling to have done something more with respect to SEMS positioning. Consequently, SEMS permits a rapid return to oral feeding as also reported in the recent literature [ 2 , 6 , 9 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 ] and confirmed by our investigation, thus accelerating the discharge of the patients from hospital and improving their return to a normal life. Furthermore, Ly J. et al [ 29 ], in a systematic review, demonstrated a higher incidence of major medical complications (respiratory tract infection, myocardial infarction, and acute renal failure) in patients who underwent surgery for palliation of malignant GOOS when compared to SEMS positioning.…”

Covered duodenal self‐expandable metal stents prolong biliary stent patency in double stenting: The largest series of bilioduodenal obstruction

“…Furthermore, duodenal U‐SEMS and C‐SEMS in patients with DS have not been compared. Duodenal U‐SEMS and C‐SEMS in patients with malignant gastric outlet obstruction did not differ in terms of their recurrent obstruction rates, overall adverse events, and times to stent dysfunction . The main causes of stent dysfunction are tumor ingrowth in U‐SEMS and stent migration in C‐SEMS .…”

“…Duodenal U-SEMS and C-SEMS in patients with malignant gastric outlet obstruction did not differ in terms of their recurrent obstruction rates, overall adverse events, and times to stent dysfunction. [40][41][42] The main causes of stent dysfunction are tumor ingrowth in U-SEMS and stent migration in C-SEMS. 41 Tumor ingrowth in U-SEMS occurs in 4% to 26% of patients with duodenal U-SEMS, 43 similar to our findings (U-SEMS vs C-SEMS: 7.7% [5/65] vs 0.0% [0/44]; P = 0.08).…”

“…[40][41][42] The main causes of stent dysfunction are tumor ingrowth in U-SEMS and stent migration in C-SEMS. 41 Tumor ingrowth in U-SEMS occurs in 4% to 26% of patients with duodenal U-SEMS, 43 similar to our findings (U-SEMS vs C-SEMS: 7.7% [5/65] vs 0.0% [0/44]; P = 0.08). In duodenal C-SEMS, stent migration is a major adverse event that requires re-intervention and occurs at a frequency of 16% to 25%.…”

Successful peroral endoscopic removal of migrated metal stent

“…Duodenal covered self-expandable metal stents (C-SEMSs) are designed with stent mesh to prevent tumor ingrowth [1]. However, stent migration is a major adverse event associated with C-SEMS, occurring in 8 % -25 % of cases [2,3]. In some cases, migrated stents exit via the rectum or remain in the body without complications [4].…”