Enteral self-expandable metal stent for malignant luminal obstruction of the upper and lower gastrointestinal tract: a prospective multicentric study.
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.
Masci
Enzo
E
Division of Gastroenterology and Gastrointestinal Endoscopy, University Vita-Salute San Raffaele, San Raffaele Hospital, Via Olgettina 60, Milan, Italy. masci.enzo@hsr.it
Viale
Edi
E
Mangiavillano
Benedetto
B
Contin
Guglielmo
G
Lomazzi
Alfredo
A
Buffoli
Federico
F
Gatti
Mario
M
Repaci
Giuseppe
G
Teruzzi
Vittorio
V
Fasoli
Renato
R
Ravelli
Paolo
P
Testoni
Pier Alberto
PA
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
D008670:Metals