Treatment of malignant gastroduodenal obstruction with a nitinol self-expanding metal stent: An international prospective multicentre registry

Costamagna, Guido; Tringali, Andrea; Špičák, Julius; Mutignani, Massimiliano; Shaw, John M.; Roy, André; Johnsson, Erik L.; Moura, Eduardo Guimarães Hourneaux de; Cheng, Spencer; Ponchon, Thierry; Bittinger, M.; Messmann, Helmut; Neuhaus, Horst; Schumacher, Brigitte; Laugier, R.; Saarnio, Juha; Ariqueta, Francisco Igea

doi:10.1016/j.dld.2011.08.012

Cited by 72 publications

(69 citation statements)

References 23 publications

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“…Palliation of obstructive symptoms and resumption of oral intake is essential to reduce morbidity and improve the quality of life [2,3,6,19]. Although both open and laparoscopic palliative gastrojejunostomies have been used as the standard approach, enteral stenting as a minimally invasive technique for the treatment of GOO has been increasingly used in recent years [1][2][3][4][5][6][7][11][12][13][14][15][18][19][20][21] ( Table 4). Three randomized trials have compared enteral stenting with surgery [15,22,23].…”

Section: Discussionmentioning

confidence: 99%

“…First reported by Truong et al [8], self-expandable metal stents (SEMS) have been increasingly used as a safe, minimally invasive, nonsurgical, palliative treatment for malignant GOO [1][2][3][4][5][6][7][9][10][11][12][13]. A large systematic review of patients undergoing SEMS placement for malignant GOO indicated high levels of technical and clinical success rates and an acceptable complication rate [9].…”

Section: Introductionmentioning

confidence: 99%

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Oral intake throughout the patients’ lives after palliative metallic stent placement for malignant gastroduodenal obstruction

Canena

Lagos

Marques³

et al. 2012

European Journal of Gastroenterology & Hepatology

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Oral intake throughout the patients’ lives after palliative metallic stent placement for malignant gastroduodenal obstruction

Canena

Lagos

Marques³

et al. 2012

European Journal of Gastroenterology & Hepatology

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“…The reported rate for adverse events including stent dysfunction after deployment of SEMS for patients with malignant GOO is 15-48% ( Table 1) (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18). The rates of stent dysfunction and other adverse events are 5-40% and 0-23%, respectively.…”

Section: Adverse Eventsmentioning

confidence: 97%

“…Reasons for unsuccessful deployment of a SEMS included unsuccessful passage of the guidewire or stent delivery system because of severity of the stricture (8,12), perforation during the procedure (9,16), insufficient deployment (11), and functional problems with SEMSs (6). Though definitions of clinical success differ slightly among studies, the rates of clinical success, which are indicated by an improvement in the GOO ranged from 77-94% (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18). Median survival after deployment of a SEMS was reported to be approximately 3 months or less in most reports.…”

Section: Introductionmentioning

confidence: 99%

“…Table 1 shows clinical results of prospective and multicenter studies of endoscopic treatment using SEMS for patients with malignant GOO. These reports show a technical success rate for the endoscopic deployment of a SEMS in patients with malignant GOO ranging from 95-100% (Table 1) (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18). Reasons for unsuccessful deployment of a SEMS included unsuccessful passage of the guidewire or stent delivery system because of severity of the stricture (8,12), perforation during the procedure (9,16), insufficient deployment (11), and functional problems with SEMSs (6).…”

Section: Introductionmentioning

confidence: 99%

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Recent advancements in stent therapy in patients with malignant gastroduodenal outlet obstruction

2017

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Gastric outlet obstruction (GOO) is one of severe comorbidities caused by many kinds of malignant diseases and is associated with not only degradation of patients' quality of life but also mortality. Although surgical bypass is one of the main therapies for malignant GOO, it is often difficult to perform in end-stage patients. The deployment of self-expandable metallic stents (SEMSs) has recently become a viable alternative to surgical bypass for malignant GOO. This technique is less invasive and more effective, particularly in patients with poor prognoses.Many reports have referred to the feasibility, effectiveness, and safety of the placement of SEMSs for malignant GOO. According to these reports, the rates of technical and clinical success were reported to be relatively high and the rate of adverse events to be acceptable. However, precautions against severe adverse events such as massive bleeding and perforation are necessary. Several reports have described the differences in clinical results among different kinds of SEMSs. The presence of a covered design for SEMSs may affect the patency of SEMSs and the rate of stent dysfunction. Selection of the SEMS according to axial force may affect successful achievement of long patency of SEMSs and avoidance of gastroduodenal perforation at the bending site of the duodenum. Compared with high technical success rates nearing 100%, clinical success rates were usually lower than technical success. Therefore, determination of predictive factors for failure of clinical success is important. Several papers reported that low performance status could be associated with failure of clinical success. However, the association of clinical success with other factors such as carcinomatosa and ascites remains controversial, which is a problem to be solved.Reintervention with SEMS using the stent-in-stent method after stent dysfunction can be performed effectively as well as placement of the first SEMS.

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Clinical outcome of a highly flexible duodenal stent for gastric outlet obstruction: A multicenter prospective study

et al. 2020

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Background and Aim Endoscopic duodenal stenting for patients with malignant gastric outlet obstruction (GOO) has been widespread; however, clinical trials evaluating the structures of duodenal stents are lacking. Thus, we aimed to investigate the clinical outcomes of a highly flexible duodenal stent for GOO patients. Methods A prospective study of duodenal stenting for GOO patients from five hospitals between August 2017 and August 2018 was performed. WallFlex Duodenal Soft were used in all procedures. The primary endpoint was clinical success, defined as an improvement in the GOO scoring system. Results The study enrolled 31 patients (12 women, 19 men) with GOO, with a median age of 70 (range 52–90) years. Primary diseases were pancreatic cancer, gastric cancer, biliary tract cancer, and others in 14, 10, 3, and 4 patients, respectively. The technical success rate was 97%, and the clinical success rate was 87%. Simultaneous biliary drainage was performed in 19% of patients. Adverse events occurred in three patients. Chemotherapy was given in 41% of clinically successful cases, and the median overall survival time after stent placement was 82 days (range, 30–341 days), and. Stent dysfunction occurred in 30% of clinically successful cases (stent ingrowth in seven and stent overgrowth in one patient). The median time to stent dysfunction was 157 days (range, 11–183 days). Six patients were treated with additional stent placement after dysfunction. Conclusion Placement of a highly flexible duodenal stent is an effective and safe treatment for patients with GOO (UMIN‐CTR 000028783).

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Treatment of malignant gastroduodenal obstruction with a nitinol self-expanding metal stent: An international prospective multicentre registry

Cited by 72 publications

References 23 publications

Oral intake throughout the patients’ lives after palliative metallic stent placement for malignant gastroduodenal obstruction

Oral intake throughout the patients’ lives after palliative metallic stent placement for malignant gastroduodenal obstruction

Recent advancements in stent therapy in patients with malignant gastroduodenal outlet obstruction

Clinical outcome of a highly flexible duodenal stent for gastric outlet obstruction: A multicenter prospective study

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