Andrea Tringali1, Paul Didden2, Alessandro Repici3, Manon Spaander2, Michael J Bourke4, Stephen J Williams4, Julius Spicak5, Pavel Drastich5, Massimiliano Mutignani1, Vincenzo Perri1, André Roy6, Krystal Johnston7, Guido Costamagna1. 1. Digestive Endoscopy Unit, Catholic University, Rome, Italy. 2. Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, the Netherlands. 3. Digestive Endoscopy Unit, IRCCS Istituto Clinico Humanitas, Milan, Italy. 4. Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, New South Wales, Australia. 5. Department of Hepatogastroenterology, IKEM, Prague, Czech Republic. 6. Endoscopy Unit, Centre Hospitalier de l'Université de Montreal (CHUM), Hôpital Saint-Luc, Montréal Québec, Canada. 7. MED Institute, Inc, West Lafayette, Indiana, USA.
Abstract
BACKGROUND: Malignant gastric outlet obstruction is often treated by stent placement. OBJECTIVE: To investigate the outcomes of stent placement in the palliative treatment of malignant neoplasms. DESIGN: Prospective, observational, multicenter registry. SETTING: Six tertiary care centers in 5 countries. PATIENTS: A total of 108 adult patients with malignant gastric outlet obstruction. INTERVENTIONS: Placement of an uncovered, self-expandable, metal duodenal stent. MAIN OUTCOME MEASUREMENTS: The primary endpoint was stent patency at 14 days after stent implantation. Secondary endpoints included stent patency at 1, 2, 3, and 6 months, gastric outlet obstruction scoring system (GOOSS) scores at 14 days and 1, 2, 3, and 6 months after stent deployment, technical success, adverse events, and patient survival (ie, confirmed duration of the implant). RESULTS: Technical success was achieved in 99.1% of stent placements. Stent patency at 14 days was 94.6%. Kaplan-Meier estimates of stent patency were 92.9% at 1 month, 86.2% at 2 months, 81.9% at 3 months, and 63.4% at 6 months. At 14 days, GOOSS scores increased by a median of 1 point. The overall GI adverse event rate was 32.4%; however, the stent-related adverse event rate was 19.4%. The median implant duration was 47 days (range 0-195 days). LIMITATIONS: Observational study, no control group. CONCLUSIONS: Duodenal stent placement resulted in prompt relief of malignant gastric outlet obstruction and improved GOOSS scores. ( CLINICAL TRIAL REGISTRATION NUMBER: NCT00991614.).
BACKGROUND:Malignant gastric outlet obstruction is often treated by stent placement. OBJECTIVE: To investigate the outcomes of stent placement in the palliative treatment of malignant neoplasms. DESIGN: Prospective, observational, multicenter registry. SETTING: Six tertiary care centers in 5 countries. PATIENTS: A total of 108 adult patients with malignant gastric outlet obstruction. INTERVENTIONS: Placement of an uncovered, self-expandable, metal duodenal stent. MAIN OUTCOME MEASUREMENTS: The primary endpoint was stent patency at 14 days after stent implantation. Secondary endpoints included stent patency at 1, 2, 3, and 6 months, gastric outlet obstruction scoring system (GOOSS) scores at 14 days and 1, 2, 3, and 6 months after stent deployment, technical success, adverse events, and patient survival (ie, confirmed duration of the implant). RESULTS: Technical success was achieved in 99.1% of stent placements. Stent patency at 14 days was 94.6%. Kaplan-Meier estimates of stent patency were 92.9% at 1 month, 86.2% at 2 months, 81.9% at 3 months, and 63.4% at 6 months. At 14 days, GOOSS scores increased by a median of 1 point. The overall GI adverse event rate was 32.4%; however, the stent-related adverse event rate was 19.4%. The median implant duration was 47 days (range 0-195 days). LIMITATIONS: Observational study, no control group. CONCLUSIONS: Duodenal stent placement resulted in prompt relief of malignant gastric outlet obstruction and improved GOOSS scores. ( CLINICAL TRIAL REGISTRATION NUMBER: NCT00991614.).
Authors: Seung Han Kim; Hoon Jai Chun; In Kyung Yoo; Jae Min Lee; Seung Joo Nam; Hyuk Soon Choi; Eun Sun Kim; Bora Keum; Yeon Seok Seo; Yoon Tae Jeen; Hong Sik Lee; Soon Ho Um; Chang Duck Kim Journal: World J Gastroenterol Date: 2015-08-14 Impact factor: 5.742
Authors: Jin Myung Park; Byung-Hoon Min; Sang Hyub Lee; Kwang Hyun Chung; Jae Min Lee; Byeong Jun Song; Jun Kyu Lee; Ji Kon Ryu; Yong-Tae Kim Journal: Dig Dis Sci Date: 2014-09-04 Impact factor: 3.199