title: Antral localization worsens the efficacy of enteral stents in malignant digestive tumors.
abstract: OBJECTIVE
  Malignant gastric outlet obstruction can be treated by means of enteral stenting or surgical gastrojejunalanatomosis. We evaluated in a prospective and multicentre study the efficacy of the enteral stent on food intake, the quality of life impact, and the relationship between efficacy and determined clinical and technical parameters.
  
  
  METHODS
  Seventy one patients affected by symptoms arising from gastroduodenal obstruction due to malignant tumors, with criteria of irresecability, metastatic disease or very high surgical risk, were treated by means of self expanding metal stents. We used the GOOSS index to evaluate efficacy, and the Euro Qol-5D index to evaluate quality of life.
  
  
  RESULTS
  Before stenting patients with GOOSS 0 and 1 were 68 (98.5%). After stenting patients with GOOSS 2 and 3 (semisolid and solid food) were 58 (84,1%) (P<.0001). The Euro Qol-5D index measured before and a month after stenting were 10.17 and 10.04 respectively (P=.6). The median survival was 91 days (9-552). The enteral stents for localised tumors in the duodenum and the gastrojejunalanastomosis were effective in 26 patients (70.2%) and 13 patients respectively (86.6%), while the enteral stents of tumors in the antrum were effective in only 5 patients (29.4%).
  
  
  CONCLUSIONS
  The palliative treatment of malignant gastric outlet obstruction with a uncovered metal stent produces a significant improvement of oral food intake and maintains the overall quality of life index. The antral localization is associated with a lower efficacy of the procedure.
authors.affiliation: Servicio de Aparato Digestivo, Hospital Son Llàtzer, Palma de Mallorca, Spain. cdolzaba@hsll.es
authors.forename: Carlos
authors.initials: C
authors.lastname: Dolz
authors.forename: Àngels
authors.initials: À
authors.lastname: Vilella
authors.forename: Pedro
authors.initials: P
authors.lastname: González Carro
authors.forename: Ferran
authors.initials: F
authors.lastname: González Huix
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Espinós
authors.forename: Santos
authors.initials: S
authors.lastname: Santolaria
authors.forename: Francisco
authors.initials: F
authors.lastname: Pérez Roldán
authors.forename: Montserrat
authors.initials: M
authors.lastname: Figa
authors.forename: Carmen
authors.initials: C
authors.lastname: Loras
authors.forename: Hernán
authors.initials: H
authors.lastname: Andreu
mesh_terms: D000368:Aged; D004067:Digestive System Neoplasms / Q000150:complications; D004380:Duodenal Obstruction / Q000209:etiology / Q000601:surgery*; D005260:Female; D017219:Gastric Outlet Obstruction / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011706:Pyloric Antrum; D015607:Stents