title: Clinical outcomes and patency of self-expanding metal stents in patients with malignant upper gastrointestinal obstruction.
abstract: This study was performed to evaluate clinical outcomes and factors associated with patency of self-expanding metal stents (SEMS) in patients with malignant upper gastrointestinal (UGI) obstruction. In 83 patients with malignant UGI obstruction, 118 SEMS placements were performed. Obstruction sites were esophagus/gastro-esophageal junction (GEJ) and gastric outlet (GO) in 41 and 42 patients, respectively. Technical success was achieved in 99.2% and clinical success in 90.5%, with no procedure-related complications. Re-obstruction and migration occurred in 38.1% during a mean follow-up of 137 days; both occurred significantly more often with GO than esophageal/GEJ obstruction (49.2% vs 23.9%). Patency rates of esophageal/GEJ obstruction were 93.5, 78.1 and 67.0% at 30, 90 and 180 days, respectively, and were significantly higher than those of GO obstruction-71.7, 51.8 and 32.5%. Palliative chemotherapy or radiation therapy was not associated with stent patency. Endoscopic SEMS placement is a safe and effective palliative treatment for malignant UGI obstruction, and complications or stent patency differed according to obstruction site.
authors.affiliation: Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744, Republic of Korea.
authors.forename: Jong Pil
authors.initials: JP
authors.lastname: Im
authors.forename: Jung Mook
authors.initials: JM
authors.lastname: Kang
authors.forename: Sang Gyun
authors.initials: SG
authors.lastname: Kim
authors.forename: Joo Sung
authors.initials: JS
authors.lastname: Kim
authors.forename: Hyun Chae
authors.initials: HC
authors.lastname: Jung
authors.forename: In Sung
authors.initials: IS
authors.lastname: Song
mesh_terms: D000368:Aged; D015331:Cohort Studies; D004867:Equipment Design; D004943:Esophagogastric Junction; D005260:Female; D017219:Gastric Outlet Obstruction / Q000209:etiology* / Q000473:pathology / Q000601:surgery*; D005770:Gastrointestinal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008297:Male; D008670:Metals; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D016896:Treatment Outcome