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Through-the-scope stent for malignant gastric outlet obstruction
D W H Lee1, A C W Chan, E K W Ng
1Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
Hong Kong Medical Journal = Xianggang Yi Xue Za Zhi
|January 28, 2003
Summary
Through-the-scope (TTS) stent placement effectively palliates malignant gastric outlet obstruction in 82% of patients. This minimally invasive technique offers a safe and feasible alternative for symptom relief in inoperable tumors.
Area of Science:
- Gastroenterology
- Interventional Endoscopy
- Oncology
Background:
- Malignant gastric outlet obstruction (GOO) significantly impacts patient quality of life.
- Palliative treatment aims to relieve obstructive symptoms and improve survival.
- Endoscopic stenting is a key intervention for GOO management.
Purpose of the Study:
- To evaluate the technique and outcomes of through-the-scope (TTS) stent placement for malignant GOO.
- To assess the safety, feasibility, and efficacy of TTS stenting in palliative care.
Main Methods:
- Seventeen patients with malignant GOO underwent TTS stent placement using conscious sedation and fluoroscopy.
- Enteral Wallstents (20-22 mm diameter, 60-90 mm length) were delivered via endoscope with ≥3.7 mm channel.
- Data collected included procedural success, complications, symptom relief, and survival metrics.
Main Results:
- Eighteen stents were placed in 17 patients; one deployment failed, and one stent migrated.
- Symptomatic relief was achieved in 14 patients (82%).
- Median dysphagia score improved from 4 to 2 (P=0.001); median overall survival was 6 weeks.
Conclusions:
- Through-the-scope stent placement is a safe and feasible endoscopic technique for palliating malignant GOO.
- It offers an effective, minimally invasive alternative for symptom management in patients with inoperable tumors.
- TTS stenting improves dysphagia and provides a palliative option with acceptable survival outcomes.