Palliation of anastomotic obstructions in recurrent gastric carcinoma with the use of covered metallic stents: clinical results in 25 patients.
BACKGROUND
The purpose of this study was to investigate the technical feasibility and the clinical effectiveness of the placement of covered self-expandable metallic stents for the treatment of anastomotic obstructions in recurrent gastric carcinoma.


METHODS
With fluoroscopic guidance, covered stents were placed in 25 patients with recurrent gastric carcinoma for the palliation of obstructions at anastomotic sites (14 gastrojejunostomy, 11 esophagojejunostomy). All patients had severe nausea and recurrent vomiting before the stent placement.


RESULTS
Stent placement was technically successful in 24 patients (96%). After stent placement, symptoms improved in all 24 patients. During the follow-up of 2 to 65 weeks (mean, 13.7 weeks), stent migration occurred in 1 patient 16 days after the procedure. He needed percutaneous catheter drainage because of an abscess, which was followed by esophagojejunostomy site rupture during a second stent trial. Stricture recurred in 4 patients because of tumor overgrowth 10 to 55 weeks after the procedure; all patients underwent coaxial placement of a second stent and had good oral intake.


CONCLUSIONS
The placement of covered expandable metallic stents seems to be both technically feasible and an effective means for the palliation of anastomotic obstructions in recurrent gastric carcinoma. This procedure can be considered to be the primary choice for the palliation in those patients.
Jeong
Jun Yong
JY
Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.
Kim
Young Jun
YJ
Han
Joon Koo
JK
Lee
Jeong Min
JM
Lee
Kyoung Ho
KH
Choi
Byung Ihn
BI
Yang
Han-Kwang
HK
Lee
Kuhn Uk
KU
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D004947:Esophagus / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D017219:Gastric Outlet Obstruction / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007582:Jejunostomy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000150:complications / Q000601:surgery; D010166:Palliative Care; D015607:Stents; D013270:Stomach / Q000601:surgery; D013274:Stomach Neoplasms / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome