Self-expandable metal stents in palliation of malignant gastrointestinal obstruction: review of the current literature data and 5-year experience at Harbor-UCLA Medical Center.

Management of malignant gastrointestinal obstruction presents a significant challenge. Most patients are in a profoundly decompensated state due to underlying malignancy and are not ideal candidates for invasive surgical procedures. In recent years, self-expandable metal stents (SEMS) have emerged as an effective and safe, less invasive alternative for the treatment of malignant intestinal obstruction. Here we report a retrospective analysis of 59 SEMS placed for gastroduodenal and colorectal obstruction in 48 patients at Harbor-UCLA Medical Center during the last 5 years, as well as review the literature published on SEMS placement. Technical and clinical success rates were approximately 92% and 80%, respectively. The majority of patients tolerated oral food intake by 36 hours after SEMS. There were no major complications of perforation, bleeding, or death. Thirteen patients had obstructive symptom recurrence, which in most cases was successfully managed with additional endoscopic interventions. Our data confirm SEMS efficacy in palliation of malignant intestinal obstruction with lower rates of major complications than previously reported.