TY - JOUR
T1 - Effectiveness of self-expanding metal stents for malignant antropyloric and duodenal obstruction with a comparison between covered and uncovered stents
AU - Bang, Seungmin
AU - Kim, Hong Jeoung
AU - Park, Jeong Youp
AU - Park, Young Soo
AU - Kim, Myoung Hwan
AU - Park, Seung Woo
AU - Lee, Yong Chan
AU - Song, Si Young
PY - 2008/11
Y1 - 2008/11
N2 - Background/Aims: We evaluated overall clinical outcomes when self-expanding metal stents were used to treat malignant gastroduodenal obstruction; we also evaluated the differences in technical feasibility, effectiveness, and outcomes between covered and uncovered stents. Methodology: We reviewed 134 patients who underwent endoscopic treatment for malignant antropyloric and duodenal obstructions with self-expanding metal stents. Results: In all but two cases, the procedures were successful in restoring passage through the obstruction. Forty-two patients (31.8%) experienced stent failure during the follow-up period (23/79 (29.1%) with uncovered stents, 19/53 (35.8%) with covered stents). Stent migration was the most common cause for failure in covered stents (73.7%), while tumor ingrowth was the most common cause in uncovered stents (52.2%). The median technical survival in the uncovered stent group was similar to covered stent group (253 days vs. 247 days, p>0.05). Improvement of oral intake was associated with improvement in performance score, which was significantly improved following stent insertion (p<0.05). In addition, patients whose performance score was improved by stenting had better survival than those who did not (median survival 173 days vs. 74 days, p<0.05). Conclusions: Endoscopic stenting for malignant gastroduodenal obstruction appears to be an effective therapeutic modality in terminally ill patients, irrespective of the type of stent. Improvement in stent technology will improve patients' oral intake, which in turn will improve patients' quality of life and survival rate.
AB - Background/Aims: We evaluated overall clinical outcomes when self-expanding metal stents were used to treat malignant gastroduodenal obstruction; we also evaluated the differences in technical feasibility, effectiveness, and outcomes between covered and uncovered stents. Methodology: We reviewed 134 patients who underwent endoscopic treatment for malignant antropyloric and duodenal obstructions with self-expanding metal stents. Results: In all but two cases, the procedures were successful in restoring passage through the obstruction. Forty-two patients (31.8%) experienced stent failure during the follow-up period (23/79 (29.1%) with uncovered stents, 19/53 (35.8%) with covered stents). Stent migration was the most common cause for failure in covered stents (73.7%), while tumor ingrowth was the most common cause in uncovered stents (52.2%). The median technical survival in the uncovered stent group was similar to covered stent group (253 days vs. 247 days, p>0.05). Improvement of oral intake was associated with improvement in performance score, which was significantly improved following stent insertion (p<0.05). In addition, patients whose performance score was improved by stenting had better survival than those who did not (median survival 173 days vs. 74 days, p<0.05). Conclusions: Endoscopic stenting for malignant gastroduodenal obstruction appears to be an effective therapeutic modality in terminally ill patients, irrespective of the type of stent. Improvement in stent technology will improve patients' oral intake, which in turn will improve patients' quality of life and survival rate.
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M3 - Article
C2 - 19260483
AN - SCOPUS:60849102471
VL - 55
SP - 2091
EP - 2095
JO - Hepato-Gastroenterology
JF - Hepato-Gastroenterology
SN - 0172-6390
IS - 88
ER -