title: Metallic stent placement in the palliative treatment of malignant gastroduodenal obstructions: prospective evaluation of results and factors influencing outcome in 213 patients.
abstract: 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.
authors.affiliation: Departments of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul, Korea.
authors.forename: Jin Hyoung
authors.initials: JH
authors.lastname: Kim
authors.forename: Ho-Young
authors.initials: HY
authors.lastname: Song
authors.forename: Ji Hoon
authors.initials: JH
authors.lastname: Shin
authors.forename: Eugene
authors.initials: E
authors.lastname: Choi
authors.forename: Tae Won
authors.initials: TW
authors.lastname: Kim
authors.forename: Hwoon-Yong
authors.initials: HY
authors.lastname: Jung
authors.forename: Gin Hyug
authors.initials: GH
authors.lastname: Lee
authors.forename: Sung Koo
authors.initials: SK
authors.lastname: Lee
authors.forename: Myung-Hwan
authors.initials: MH
authors.lastname: Kim
authors.forename: Min-Hee
authors.initials: MH
authors.lastname: Ryu
authors.forename: Yoon-Koo
authors.initials: YK
authors.lastname: Kang
authors.forename: Byung Sik
authors.initials: BS
authors.lastname: Kim
authors.forename: Jeong Hwan
authors.initials: JH
authors.lastname: Yook
mesh_terms: 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
chemical_list: D000497:Alloys; C013616:nitinol