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Effectiveness of self-expanding metal stents for malignant antropyloric and duodenal obstruction with a comparison between covered and uncovered stents

Authors
 Bang S  ;  Kim HJ  ;  Park JY  ;  Park YS  ;  Kim MH  ;  Park SW  ;  Lee' YC  ;  Song SY 
Citation
 HEPATO-GASTROENTEROLOGY, Vol.55(88) : 2091-2095, 2008 
Journal Title
 HEPATO-GASTROENTEROLOGY 
ISSN
 0172-6390 
Issue Date
2008
MeSH
Adult ; Aged ; Aged, 80 and over ; Digestive System Neoplasms/complications ; Duodenal Obstruction/etiology ; Duodenal Obstruction/mortality ; Duodenal Obstruction/therapy* ; Female ; Gastric Outlet Obstruction/therapy ; Humans ; Karnofsky Performance Status ; Male ; Middle Aged ; Prosthesis Design ; Quality of Life ; Retrospective Studies ; Stents*
Keywords
Adult ; Aged ; Aged, 80 and over ; Digestive System Neoplasms/complications ; Duodenal Obstruction/etiology ; Duodenal Obstruction/mortality ; Duodenal Obstruction/therapy* ; Female ; Gastric Outlet Obstruction/therapy ; Humans ; Karnofsky Performance Status ; Male ; Middle Aged ; Prosthesis Design ; Quality of Life ; Retrospective Studies ; Stents*
Abstract
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.
DOI
19260483
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Hong Jeoung(김홍정)
Park, Seung Woo(박승우) ORCID logo https://orcid.org/0000-0001-8230-964X
Park, Jeong Youp(박정엽) ORCID logo https://orcid.org/0000-0003-0110-8606
Bang, Seungmin(방승민) ORCID logo https://orcid.org/0000-0001-5209-8351
Song, Si Young(송시영) ORCID logo https://orcid.org/0000-0002-1417-4314
Lee, Yong Chan(이용찬) ORCID logo https://orcid.org/0000-0001-8800-6906
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/108256
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