title: Enteral self-expandable metal stent for malignant luminal obstruction of the upper and lower gastrointestinal tract: a prospective multicentric study.
abstract: BACKGROUND
  Self-expanding metal stents (SEMSs) are used to treat malignant stenosis of the gastrointestinal (GI) tract, as a safe, feasible, and minimally invasive option for reestablishing luminal patency. However, the literature offers scant prospective data on the clinical outcome of these patients.
  
  
  OBJECTIVE
  To assess the technical success, complications, and clinical outcomes of patients with a SEMS placed for malignant upper and lower GI obstruction.
  
  
  METHODS
  A cohort of 110 patients with clinical symptoms related to malignant stenosis of the upper and lower GI tract were prospectively enrolled and SEMSs were placed endoscopically in 9 endoscopy centers. The patients were followed up and survival, oral intake, stool canalization, and late complications were recorded on days 30, 90, and 180.
  
  
  RESULTS
  Overall, 110 patients, 38 (34.5%) with upper and 72 (65.5%) with lower GI obstruction were examined. The procedure was successful in 102 (92.7%). There were 5 early complications (<96 h) (4.5%). Late complications (>96 h) occurred in 6 patients (6.3%). Median survival after stenting was 90 days (q1 30; q3 120). Placing the SEMS enabled 79.4%, 90.9%, and 100% of the patients to resume an oral diet at 30, 90, and 180 days, respectively. All patients had stool canalization until death.
  
  
  CONCLUSIONS
  Endoscopic stenting is an effective and safe procedure for malignant luminal obstruction of the GI tract, with good clinical outcomes in patients whose survival is unfortunately short.
authors.affiliation: Division of Gastroenterology and Gastrointestinal Endoscopy, University Vita-Salute San Raffaele, San Raffaele Hospital, Via Olgettina 60, Milan, Italy. masci.enzo@hsr.it
authors.forename: Enzo
authors.initials: E
authors.lastname: Masci
authors.forename: Edi
authors.initials: E
authors.lastname: Viale
authors.forename: Benedetto
authors.initials: B
authors.lastname: Mangiavillano
authors.forename: Guglielmo
authors.initials: G
authors.lastname: Contin
authors.forename: Alfredo
authors.initials: A
authors.lastname: Lomazzi
authors.forename: Federico
authors.initials: F
authors.lastname: Buffoli
authors.forename: Mario
authors.initials: M
authors.lastname: Gatti
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Repaci
authors.forename: Vittorio
authors.initials: V
authors.lastname: Teruzzi
authors.forename: Renato
authors.initials: R
authors.lastname: Fasoli
authors.forename: Paolo
authors.initials: P
authors.lastname: Ravelli
authors.forename: Pier Alberto
authors.initials: PA
authors.lastname: Testoni
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005770:Gastrointestinal Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D007415:Intestinal Obstruction / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D007558:Italy; D008297:Male; D008670:Metals; D008875:Middle Aged; D011446:Prospective Studies; D011474:Prosthesis Design; D019919:Prosthesis Implantation / Q000295:instrumentation*; D015607:Stents; D016896:Treatment Outcome
chemical_list: D008670:Metals