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Palliation in patients with malignant gastric outlet obstruction with a newly designed enteral stent: a multicenter
Iruru Maetani1, Hiroyuki Isayama, Yoshinori Mizumoto
1Division of Gastroenterology, Department of Internal Medicine, Toho University Ohashi Medical Center, Tokyo, Japan.
Background:
Through-the-scope (TTS) stents facilitate palliative enteral stent placement. However, most TTS stents are braided, a characteristic that has been associated with significant foreshortening and relatively frequent migration.
Objectives:
To evaluate clinical experience with a new woven enteral stent in the treatment of gastric outlet obstruction.
Design:
From January 2005 to August 2006, patients with unresectable malignant gastric outlet obstruction were offered stent placement with a new woven stent.
Setting:
Three referral hospitals in Japan.
Patients:
Thirty-seven consecutive patients with malignant gastric outlet obstruction.
Interventions:
A newly designed enteral stent was placed by using the TTS placement technique.
Main Outcome Measurements:
Palliation efficacy and safety of the new stents.
Results:
Stent placement was successful in 36 of 37 patients (technical success, 97%). Thirty-four patients were able to tolerate oral intake without obstructive symptoms (clinical success, 94.4%). Complications occurred in 16.2% of patients, comprising 2 cases of primary stent dysfunction, 1 perforation, 1 GI bleeding, 1 stent obstruction, and 1 biliary stent dysfunction. No migration was seen during the median follow-up period of 68 days.
Limitations:
Small sample size and relatively brief follow-up.
Conclusions:
A newly developed enteral stent with higher flexibility and less foreshortening offers comparable clinical outcome to existing stents and a lower frequency of complications, including migration.
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