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Dig Endosc. 2014 Apr 22. doi: 10.1111/den.12300. [Epub ahead of print]

Gastroduodenal stenting with Niti-S stent: Long-term benefits and additional stent intervention.

Author information

  • 1Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan; Division of Gastroenterology, Yokohama City University School of Medicine, Yokohama, Japan.

Abstract

BACKGROUND AND AIM:

Self-expandable metallic stents have mainly been used for the palliation of malignant gastric outlet obstruction (GOO). However, their use in long-term survivors and the feasibility, safety and benefit of additional intervention for stent dysfunction remain controversial. The present study examined the long-term benefits of endoscopic gastroduodenal stenting.

METHODS:

We reviewed 61 patients treated with Niti-S stents at several hospitals and estimated the efficacy of stent intervention, stent patency, eating period and factors related to poor effectiveness.

RESULTS:

All 61 first stent interventions and 14 additional stent interventions (11 second interventions and 3 third interventions) were successfully carried out. Clinical success rates were 83.6% and 85.7%, and median stent patency was 214 days and 146 days (P = 0.47), respectively. Fifty patients could be treated with a first stent only, and 11 patients received additional stents. At the time of study termination or death, 70.0% of the former group and 63.6% of the latter group maintained oral intake (P = 0.71), and each 86% and 100% among the group could maintain oral intake for a period exceeding half of their remaining lives after first stent intervention. Karnofsky performance status ≤50 (P = 0.03), ascites (P = 0.009), and peritoneal dissemination (P = 0.001) appeared to be factors related to poor effectiveness.

CONCLUSIONS:

Despite the presence of factors related to poor effectiveness, endoscopic gastroduodenal stenting would be the first treatment of choice for GOO and provide long-term benefits. If stent dysfunction occurs, additional stent intervention enables continued oral intake safely.

© 2014 The Authors. Digestive Endoscopy © 2014 Japan Gastroenterological Endoscopy Society.

KEYWORDS:

Niti-S gastroduodenal stenting; additional stent intervention; factors related to poor effectiveness; gastric outlet obstruction (GOO); long-term benefit

PMID:
24754262
[PubMed - as supplied by publisher]
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