BACKGROUND:Self-expandable metallic stents (SEMSs) provide effective palliation of malignant pyloric obstruction in patients with inoperable gastric cancer. OBJECTIVE: To compare the effectiveness and side effects of covered and uncovered SEMSs for the palliation of malignant pyloric obstruction. DESIGN: Prospective, randomized, single-center study. SETTING:Tertiary-care cancer center hospital. PATIENTS: This study involved 80 patients with pyloric obstruction related to inoperable gastric cancer. INTERVENTION: Covered or uncovered SEMS placement. MAIN OUTCOME MEASUREMENTS: Technical and clinical success rates as well as the patency rate at 8 weeks after placement. RESULTS: Both groups had a technical success rate of 100% with no immediate complications. Both groups also had comparable clinical success rates (covered SEMS, 95% [38 of 40] and uncovered SEMS, 90% [36 of 40], P = .68) and 8-week patency rates (covered SEMS, 61.3% [19 of 31] and uncovered SEMS, 61.1% [22 of 36], P > .99). Stent migration within 8 weeks was more common in the covered SEMS group (25.8% [8 of 31]) than in the uncovered SEMS group (2.8% [1 of 36], P = .009), whereas re-stenosis because of tumor ingrowth was more common in the uncovered SEMS group (25.0% [9 of 36] vs 0% [0 of 31] in the covered SEMS group, P = .003). Overall patient survival and stent patency did not differ between groups (P = .27 and 0.61 by log-rank test, respectively). LIMITATIONS: The study population was limited to gastric cancer patients, and stent designs were changed in the midst of the study period. CONCLUSION: Both the covered and uncovered SEMSs are effective and have comparable 8-week patency in patients with malignant pyloric obstruction, despite different patterns of late stent failure. Copyright 2010 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.
RCT Entities:
BACKGROUND: Self-expandable metallic stents (SEMSs) provide effective palliation of malignant pyloric obstruction in patients with inoperable gastric cancer. OBJECTIVE: To compare the effectiveness and side effects of covered and uncovered SEMSs for the palliation of malignant pyloric obstruction. DESIGN: Prospective, randomized, single-center study. SETTING: Tertiary-care cancer center hospital. PATIENTS: This study involved 80 patients with pyloric obstruction related to inoperable gastric cancer. INTERVENTION: Covered or uncovered SEMS placement. MAIN OUTCOME MEASUREMENTS: Technical and clinical success rates as well as the patency rate at 8 weeks after placement. RESULTS: Both groups had a technical success rate of 100% with no immediate complications. Both groups also had comparable clinical success rates (covered SEMS, 95% [38 of 40] and uncovered SEMS, 90% [36 of 40], P = .68) and 8-week patency rates (covered SEMS, 61.3% [19 of 31] and uncovered SEMS, 61.1% [22 of 36], P > .99). Stent migration within 8 weeks was more common in the covered SEMS group (25.8% [8 of 31]) than in the uncovered SEMS group (2.8% [1 of 36], P = .009), whereas re-stenosis because of tumor ingrowth was more common in the uncovered SEMS group (25.0% [9 of 36] vs 0% [0 of 31] in the covered SEMS group, P = .003). Overall patient survival and stent patency did not differ between groups (P = .27 and 0.61 by log-rank test, respectively). LIMITATIONS: The study population was limited to gastric cancerpatients, and stent designs were changed in the midst of the study period. CONCLUSION: Both the covered and uncovered SEMSs are effective and have comparable 8-week patency in patients with malignant pyloric obstruction, despite different patterns of late stent failure. Copyright 2010 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.
Authors: Chan Gyoo Kim; Il Ju Choi; Jong Yeul Lee; Soo-Jeong Cho; Soo Jin Kim; Mi-Jung Kim; Sook Ryun Park; Young Lee Park Journal: Surg Endosc Date: 2013-09-12 Impact factor: 4.584
Authors: Ji Won Kim; Ji Bong Jeong; Kook Lae Lee; Byeong Gwan Kim; Dong Won Ahn; Jae Kyung Lee; Su Hwan Kim Journal: World J Gastroenterol Date: 2015-02-07 Impact factor: 5.742