Usefulness of a Guiding Sheath for Fluoroscopic Stent Placement in Patients with Malignant Gastroduodenal Obstruction

Park, Jung Hoon; Song, Ho Young; Kim, Myoung Sun; Chung, Rosa; Kim, Jin Hyoung; Na, Han Kyu; Nam, Doo Hyun

doi:10.1258/ar.2012.120621

Cited by 16 publications

(9 citation statements)

References 13 publications

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“…This result is consistent with previous reports [ 6 , 28 , 30 ]. Uncovered stents are accepted as standard for the treatment of malignant GOOs [ 11 , 16 ] because they are effective in preventing stent migration and tend to remain patent longer than covered stents. In addition, covered stents are associated with a more frequent need for reintervention than uncovered stents [ 20 , 32 ].…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, standard covered and uncovered stents have high migration and restenosis rates [ 10 – 14 ]. Although double- and triple-layer stents seem to prevent migration and tumor ingrowth [ 8 , 15 , 16 ], the shapes and sizes of the gastric cavities are usually not considered in these improved stents [ 15 , 17 ]. Our hypothesis was that unresectable GOO tailored covered stents are superior to the standard uncovered ones in terms of stent reobstruction and stent migration.…”

Section: Introductionmentioning

confidence: 99%

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A Multicenter Randomized Controlled Trial of Malignant Gastric Outlet Obstruction: Tailored Partially Covered Stents (Placed Fluoroscopically) versus Standard Uncovered Stents (Placed Endoscopically)

Ding

Bao³

et al. 2014

Gastroenterology Research and Practice

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The aim of our study is to compare the efficacy and safety of “outlet-shape” tailored stents with standard stents for the management of distal gastric cancer causing gastric outlet obstructions (GOOs) with varying gastric cavity shapes and sizes. To determine the shape and size of the GOOs, stomach opacifications were performed using contrast media before stenting. Two basic shapes of the residual cavity of the proximal GOO were observed: cup shaped or approximately cup shaped and funnel shaped or approximately funnel shaped. Other shapes were not found. In the GOO tailored group, the size and shape of the proximal ends of the tailored stent were suited for the residual cavity of the proximal GOO. The tailored stents included large cup-shaped stents and large funnel-shaped stents. GOO tailored covered stents led to less restenosis and reintervention rates compared to standard uncovered stents but with the same survival.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Multicenter Randomized Controlled Trial of Malignant Gastric Outlet Obstruction: Tailored Partially Covered Stents (Placed Fluoroscopically) versus Standard Uncovered Stents (Placed Endoscopically)

Ding

Bao³

et al. 2014

Gastroenterology Research and Practice

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“…To reduce the possibility of looping, it is recommended that a nasogastric tube must be placed at least 24 hours before the procedure to decompress the stomach. 30 Park et al 31 has described of using a guiding sheath for the assistance of stent placement in patients with malignant GOO. The sheath can help overcome the problem of guidewire looping, with an overall technical success of 98%.…”

Section: Over-the-wire Techniquementioning

confidence: 99%

Minimally Invasive Interventional Management of Gastric Outlet Obstructions

Zhou

Yang

2018

Dig Dis Interv

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Gastric outlet obstruction (GOO) is a clinical consequence of any disease that produces intrinsic or extrinsic obstruction of the pyloric channel or duodenum. The most common symptoms of GOO include nausea, vomiting, abdominal pain, and weight loss. Traditionally, surgery is regarded as the standard treatment modality. However, with the development of mini-invasive technologies, fluoroscopic or endoscopic stenting and balloon dilatation have become the mainstream of the therapies. The initial recommended treatment for malignant GOO is self-expanding metal stent placement. The stent can be classified into covered and uncovered stent according to whether it is coated with a membrane. Covered stent seems to have longer stent patency, while uncovered stent has the advantage of a lower migration rate. Regarding the etiology of benign GOO, peptic ulcer disease and corrosive injury are the two main reasons. Balloon dilatation is a simple and convenient way to treat the benign GOO. Stent placement has recently been reported for the treatment of benign GOO; however, it needs further more studies to verify its effect. This article presents a concise review of current fluoroscopic or endoscopic stenting practice for malignant GOO and balloon dilatation or stenting for benign GOO.

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“…6 When buckling or loop formation of the apparatus occurs in the distended remnant esophagus or stomach, an 18 Fr, 60°J-shaped guiding sheath (S&G Biotech, Seongnam, Korea) can be useful to facilitate advancement of the delivery system through the stricture. 27 If the SEMS does not expand to at least 50% of its maximal diameter after placement, balloon dilation of the SEMS can be performed to hasten stent expansion.…”

Section: Sems Placement Proceduresmentioning

confidence: 99%

Stent Placement in Surgically Altered Stomach

et al. 2018

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Gastric cancer is one of the most common malignancies and among the leading causes of cancer-related deaths worldwide. Radical gastrectomy has been the mainstay of curative treatment for gastric cancer, but recurrent cancer occurs in a significant number of patients. Patients with recurrent cancer can experience debilitating symptoms due to malignant gastric outlet obstruction (GOO). Self-expandable metallic stent (SEMS) placement is effective and safe for the palliative treatment of malignant GOO. However, the technical difficulty of SEMS placement is higher in patients with recurrent cancer due to the surgically altered stomach. Thorough understanding of the surgically altered anatomy and site of stricture is key to favorable treatment outcomes.

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Usefulness of a Guiding Sheath for Fluoroscopic Stent Placement in Patients with Malignant Gastroduodenal Obstruction

Abstract: Using a guiding sheath for fluoroscopic stent placement appears to be feasible, useful and safe in patients with malignant gastroduodenal obstructions.

Cited by 16 publications

References 13 publications

A Multicenter Randomized Controlled Trial of Malignant Gastric Outlet Obstruction: Tailored Partially Covered Stents (Placed Fluoroscopically) versus Standard Uncovered Stents (Placed Endoscopically)

A Multicenter Randomized Controlled Trial of Malignant Gastric Outlet Obstruction: Tailored Partially Covered Stents (Placed Fluoroscopically) versus Standard Uncovered Stents (Placed Endoscopically)

Minimally Invasive Interventional Management of Gastric Outlet Obstructions

Stent Placement in Surgically Altered Stomach

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