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Clinical outcomes of secondary stent-in-stent self-expanding metal stent placement for primary stent malfunction in malignant gastric outlet obstruction.

Authors
 Jun Chul Park  ;  Jae Jun Park  ;  Kungseok Cheoi  ;  Hyunsoo Chung  ;  Hyuk Lee  ;  Sung Kwan Shin  ;  Sang Kil Lee  ;  Yong Chan Lee 
Citation
 Digestive and Liver Disease, Vol.44(12) : 999-1005, 2012 
Journal Title
 Digestive and Liver Disease 
ISSN
 1590-8658 
Issue Date
2012
MeSH
Adult ; Aged ; Aged, 80 and over ; Digestive System Neoplasms/complications* ; Digestive System Neoplasms/mortality ; Feasibility Studies ; Female ; Follow-Up Studies ; Gastric Outlet Obstruction/etiology ; Gastric Outlet Obstruction/mortality ; Gastric Outlet Obstruction/therapy* ; Gastroscopy* ; Humans ; Kaplan-Meier Estimate ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Palliative Care/methods* ; Prosthesis Failure*/etiology ; Retrospective Studies ; Risk Factors ; Stents* ; Treatment Outcome
Keywords
Self-expanding metal stent ; Stent-in-stent ; Gastric outlet obstruction
Abstract
BACKGROUND: Although a substantial number of patients require secondary stents insertion due to primary stent malfunction in malignant gastric outlet obstruction, data on the outcomes of secondary self-expanding metal stents are sparse. AIM: To investigate clinical outcomes and factors related with secondary stent malfunction in patients with malignant gastric outlet obstruction given secondary stent-in-stent self-expanding metal stent insertion. METHODS: For this retrospective study, a total 77 patients who underwent secondary stent-in-stent self-expanding metal stent placement for primary stent malfunction in malignant gastric outlet obstruction were enrolled. We compared the effectiveness and complications of secondary covered and uncovered stents and explored the predictive factors for stent malfunction. RESULTS: Stent-in-stent self-expanding metal stent placements were technically successful in all patients. Both groups also had comparable clinical success rates (covered stent, 87.2% and uncovered stent, 90.0%, P = 1.000). Stent malfunction rates (31.9% and 36.7% respectively, P = 0.805) and median patency time of stent (165 [95% confidence interval: 112-218] and 165 [95% confidence interval: 126-204] days, respectively, P = 0.358) were similar between secondary covered and uncovered stents. Longer patients' survival time (≥ 100 days) was associated with increased risk of stent malfunction (odds ratio: 4.598; 95% confidence interval: 1.473-14.355; P = 0.009). CONCLUSIONS: Secondary stent-in-stent self-expanding metal stent placement is feasible and effective treatment for primary stent malfunctions in malignant gastric outlet obstruction. Covered and uncovered stent are equally acceptable in terms of stent-related complications and stent patency, regardless of primary stent type.
Full Text
http://www.sciencedirect.com/science/article/pii/S1590865812002472
DOI
22835857
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Park, Jae Jun(박재준)
Park, Jun Chul(박준철) ORCID logo https://orcid.org/0000-0001-8018-0010
Shin, Sung Kwan(신성관) ORCID logo https://orcid.org/0000-0001-5466-1400
Lee, Sang Kil(이상길) ORCID logo https://orcid.org/0000-0002-0721-0364
Lee, Yong Chan(이용찬) ORCID logo https://orcid.org/0000-0001-8800-6906
Lee, Hyuk(이혁)
Cheoi, Kyung Seok(최경석)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/90139
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