Metallic stent placement in the palliative treatment of malignant gastroduodenal obstructions: prospective evaluation of results and factors influencing outcome in 213 patients.
BACKGROUND
Metallic stents are a therapeutic option for patients with malignant GI obstruction.


OBJECTIVE
Our purpose was to evaluate the clinical effectiveness of a self-expandable metallic stent in 213 patients with malignant gastroduodenal obstruction and to identify prognostic factors associated with clinical outcomes.


METHODS
Prospective cohort study.


METHODS
Single tertiary referral university hospital.


METHODS
Two hundred thirteen consecutive patients with symptomatic malignant gastric outlet or duodenal obstruction from 2001 to 2005.


METHODS
Placement of a self-expandable metallic stent.


METHODS
Prospective data collection focused on technical and clinical success, complications, and prognostic factors associated with stent patency.


RESULTS
Technical and clinical success were achieved in 94% and 94% of the patients, respectively, and the complication rate was 21%. The median and mean survival periods were 99 (95% CI, 78-121) and 159 days (95% CI, 116-203). The median and mean stent patency periods were 270 (95% CI, 234-413) and 324 days (95% CI, 128-412). With use of the multivariate Cox proportional hazard model, chemotherapy after stent placement (odds ratio, 0.19; 95% CI, 0.08-0.46; P < .001) was significantly associated with an increase in the maintenance of stent patency.


CONCLUSIONS
Single-center experience and the lack of a control group.


CONCLUSIONS
Placement of a self-expandable metallic stent is clinically effective in patients with unresectable gastric outlet or duodenal obstruction. Chemotherapy after stent placement, albeit associated with increased migration rates, is associated with an increase in the maintenance of stent patency.
Kim
Jin Hyoung
JH
Departments of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul, Korea.
Song
Ho-Young
HY
Shin
Ji Hoon
JH
Choi
Eugene
E
Kim
Tae Won
TW
Jung
Hwoon-Yong
HY
Lee
Gin Hyug
GH
Lee
Sung Koo
SK
Kim
Myung-Hwan
MH
Ryu
Min-Hee
MH
Kang
Yoon-Koo
YK
Kim
Byung Sik
BS
Yook
Jeong Hwan
JH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000497:Alloys; D004380:Duodenal Obstruction / Q000209:etiology / Q000601:surgery*; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005471:Fluoroscopy; D017219:Gastric Outlet Obstruction / Q000209:etiology / Q000601:surgery*; D005770:Gastrointestinal Neoplasms / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D015607:Stents / Q000009:adverse effects
D000497:Alloys; C013616:nitinol