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What is the ideal stent as initial intervention for malignant gastric outlet obstruction?

Authors
 Chan Ik Park  ;  Jie-Hyun Kim  ;  Yong Chan Lee  ;  Jaehoon Jahng  ;  Young Hoon Youn  ;  Hyojin Park  ;  Sang In Lee 
Citation
 Digestive and Liver Disease, Vol.45(1) : 33-37, 2013 
Journal Title
 Digestive and Liver Disease 
ISSN
 1590-8658 
Issue Date
2013
MeSH
Aged ; Combined Modality Therapy ; Drug Therapy ; Female ; Gastric Outlet Obstruction/drug therapy ; Gastric Outlet Obstruction/etiology ; Gastric Outlet Obstruction/mortality ; Gastric Outlet Obstruction/therapy* ; Gastroscopy ; Humans ; Male ; Middle Aged ; Postoperative Complications ; Prosthesis Failure ; Retrospective Studies ; Stents* ; Stomach Neoplasms/complications ; Stomach Neoplasms/drug therapy ; Stomach Neoplasms/mortality ; Stomach Neoplasms/therapy* ; Survival Rate ; Treatment Outcome
Keywords
Chemotherapy ; Malignant gastric outlet obstruction ; Patency ; Self-expandable metal stent (SEMS)
Abstract
BACKGROUND: Self-expandable metal stents are effective palliation for malignant gastric outlet obstruction. The aims of study were to evaluate efficacy and safety of double-layered Comvi, uncovered and covered stent to find out protocols which enhance stent patency. METHODS: We retrospectively analysed data from 224 patients who underwent endoscopic stent placement for malignant gastric outlet obstruction caused by stomach cancer from 2006 to 2011. Technical and clinical success rates were evaluated and clinical outcomes were compared according to stent types and chemotherapy. RESULTS: The overall technical and clinical success rates were achieved in 99.6% and 80.4%, respectively without immediate complications. The clinical success rate was not significantly different between three groups. The median stent patency time was 156 days [interquartile range 66-279] without differences between groups. The 4-, 8-, and 12-week patency rates were 89.4%, 77.3%, and 61.2%, respectively with no differences between groups. The re-stenosis of stent frequently occurred in the case of the uncovered stents, while migration was more likely to be observed for the covered and Comvi stent. Chemotherapy significantly lowered re-intervention rates, especially in uncovered stents. CONCLUSIONS: Patency rates are significantly improved by combining the use of uncovered stent with follow-up chemotherapy treatment, which retains the advantages of the mechanical and chemical aspects of stent and chemotherapy, respectively.
Full Text
http://www.sciencedirect.com/science/article/pii/S1590865812003295
DOI
10.1016/j.dld.2012.08.021
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jie-Hyun(김지현) ORCID logo https://orcid.org/0000-0002-9198-3326
Park, Hyo Jin(박효진) ORCID logo https://orcid.org/0000-0003-4814-8330
Youn, Young Hoon(윤영훈) ORCID logo https://orcid.org/0000-0002-0071-229X
Lee, Sang In(이상인)
Lee, Yong Chan(이용찬) ORCID logo https://orcid.org/0000-0001-8800-6906
Jahng, Jae Hoon(장재훈)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/86351
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