A Novel Partially Covered Self-Expandable Metallic Stent with Proximal Flare in Patients with Malignant Gastric Outlet Obstruction.
- Author:
Naminatsu TAKAHARA
1
;
Hiroyuki ISAYAMA
;
Yousuke NAKAI
;
Shuntaro YOSHIDA
;
Tomotaka SAITO
;
Suguru MIZUNO
;
Hiroshi YAGIOKA
;
Hirofumi KOGURE
;
Osamu TOGAWA
;
Saburo MATSUBARA
;
Yukiko ITO
;
Natsuyo YAMAMOTO
;
Minoru TADA
;
Kazuhiko KOIKE
Author Information
- Publication Type:Multicenter Study ; Original Article
- Keywords: Gastric outlet obstruction; Self expandable metal stent; Endoscopic stent placement
- MeSH: Gastric Outlet Obstruction*; Humans; Palliative Care; Pancreatitis; Retrospective Studies; Self Expandable Metallic Stents; Stents*; Tertiary Care Centers
- From:Gut and Liver 2017;11(4):481-488
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: Endoscopic placement of self-expandable metal stents (SEMSs) has emerged as a palliative treatment for malignant gastric outlet obstruction (GOO). Although covered SEMSs can prevent tumor ingrowth, frequent migration of covered SEMSs may offset their advantages in preventing tumor ingrowth. METHODS: We conducted this multicenter, single-arm, retrospective study at six tertiary referral centers to evaluate the safety and efficacy of a partially covered SEMS with an uncovered large-bore flare at the proximal end as an antimigration system in 41 patients with symptomatic malignant GOO. The primary outcome was clinical success, and the secondary outcomes were technical success, stent dysfunction, adverse events, and survival after stent placement. RESULTS: The technical and clinical success rates were 100% and 95%, respectively. Stent dysfunctions occurred in 17 patients (41%), including stent migration in nine (23%), tumor ingrowth in one (2%), and tumor overgrowth in four (10%). Two patients (5%) developed adverse events: one pancreatitis and one perforation. No procedure-related death was observed. CONCLUSIONS: A novel partially covered SEMS with a large-bore flare proximal end was safe and effective for malignant GOO but failed to prevent stent migration. Further research is warranted to develop a covered SEMS with an optimal antimigration system.
