title: Peroral placement of a self-expandable covered metallic stent using an overtube for malignant gastroduodenal obstructions.
abstract: OBJECTIVE
  To evaluate the technical feasibility and safety of overtube-guided covered metallic stent placement as palliative treatment for patients with inoperable malignant gastric outlet obstructions.
  
  
  METHODS
  To relieve the symptoms of severe nausea and recurrent vomiting in five patients with inoperable gastric cancer, we used an overtube (Long overtube; Sumitomo Bakelite, Tokyo, Japan) to place large-diameter, self-expandable, covered esophageal Ultraflex stents (inner diameter 22-28 mm, length 10 or 12 cm; Boston Scientific, Watertown, MA, USA). Success was defined both technically and clinically.
  
  
  RESULTS
  The stent placement was technically successful in all patients and resulted in improvement of symptoms in all five patients, four of whom were thereafter able to ingest solid food. The remaining patient, a 94-year-old man, was unable to ingest food because of dysmasesis. During the mean follow-up of 17 weeks, there was no stent reocclusion and no life-threatening complications developed.
  
  
  CONCLUSIONS
  The placement of a large diameter, self-expandable, covered esophageal stent using an overtube appears to be effective for the palliative treatment of malignant gastric outlet obstruction.
authors.affiliation: Department of Surgery, Oita Prefectural Hospital, 476 Oaza-Bunyou, Oita, 870-8511, Japan.
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Ikeda
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Ueda
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Yonemura
authors.forename: Kohjiro
authors.initials: K
authors.lastname: Mashino
authors.forename: Akira
authors.initials: A
authors.lastname: Kabashima
authors.forename: Kiminori
authors.initials: K
authors.lastname: Watanabe
authors.forename: Kyuzo
authors.initials: K
authors.lastname: Fujii
authors.forename: Hideya
authors.initials: H
authors.lastname: Tashiro
authors.forename: Hisanobu
authors.initials: H
authors.lastname: Sakata
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020099:Coated Materials, Biocompatible; D004380:Duodenal Obstruction / Q000628:therapy*; D005260:Female; D017219:Gastric Outlet Obstruction / Q000628:therapy; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D015607:Stents; D013274:Stomach Neoplasms / Q000150:complications
chemical_list: D020099:Coated Materials, Biocompatible