Anastomotic recurrence of gastric cancer after total gastrectomy with esophagojejunostomy: palliation with covered expandable metallic stents.
OBJECTIVE
To assess the technical feasibility, safety, and clinical effectiveness of the placement of expandable metallic stents in patients with anastomotic recurrence of gastric cancer after total gastrectomy with esophagojejunostomy.


METHODS
The authors retrospectively analyzed data from 32 patients in whom metallic stents were placed for recurrent obstruction after total gastrectomy with esophagojejunostomy. Technical and clinical success and complications with related interventions were evaluated. Overall survival and stent patency rates were calculated according to the Kaplan-Meier method.


RESULTS
Stent placement was technically successful in 30 of the 32 patients (94%). After stent placement, 29 patients (91%) experienced improvement of their symptoms. Fourteen complications occurred after stent placement, and these consisted of pain (n = 5, 16%), stent migration (n = 3, 9%), stent obstruction due to tumor overgrowth (n = 4, 13%), and abutment of the tortuous jejunal wall by the end of the stent (n = 2, 6%). In one of five patients with pain, the stent was removed 4 hours after placement because the pain could not be controlled with analgesics. The median survival and stent patency period were 87.0 and 140.0 days, respectively.


CONCLUSIONS
Placement of covered metallic stents in patients with anastomotic recurrence of gastric cancer after total gastrectomy with esophagojejunostomy is technically feasible, safe, and clinically effective.
Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap-2dong, Songpa-gu, Seoul, Republic of Korea.
Jin Hyoung
JH
Kim
Ho-Young
HY
Song
Ji Hoon
JH
Shin
Jin-Oh
JO
Lim
Kyung Rae
KR
Kim
Jae Hyun
JH
Kwon
Sang Woo
SW
Park
Eugene
E
Choi
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000497:Alloys / Q000627:therapeutic use; D000714:Anastomosis, Surgical; D003680:Deglutition Disorders / Q000209:etiology; D054855:Drug-Eluting Stents / Q000009:adverse effects; D004869:Equipment Safety; D004946:Esophagostomy; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D007582:Jejunostomy; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D010166:Palliative Care / Q000379:methods*; D011474:Prosthesis Design; D012086:Reoperation; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome
D000497:Alloys; C013616:nitinol