Endoscopic treatment of malignant gastric and duodenal strictures: a prospective, multicenter study.
BACKGROUND
Malignant gastric outlet obstruction is often treated by stent placement.


OBJECTIVE
To investigate the outcomes of stent placement in the palliative treatment of malignant neoplasms.


METHODS
Prospective, observational, multicenter registry.


METHODS
Six tertiary care centers in 5 countries.


METHODS
A total of 108 adult patients with malignant gastric outlet obstruction.


METHODS
Placement of an uncovered, self-expandable, metal duodenal stent.


METHODS
The primary endpoint was stent patency at 14 days after stent implantation. Secondary endpoints included stent patency at 1, 2, 3, and 6 months, gastric outlet obstruction scoring system (GOOSS) scores at 14 days and 1, 2, 3, and 6 months after stent deployment, technical success, adverse events, and patient survival (ie, confirmed duration of the implant).


RESULTS
Technical success was achieved in 99.1% of stent placements. Stent patency at 14 days was 94.6%. Kaplan-Meier estimates of stent patency were 92.9% at 1 month, 86.2% at 2 months, 81.9% at 3 months, and 63.4% at 6 months. At 14 days, GOOSS scores increased by a median of 1 point. The overall GI adverse event rate was 32.4%; however, the stent-related adverse event rate was 19.4%. The median implant duration was 47 days (range 0-195 days).


CONCLUSIONS
Observational study, no control group.


CONCLUSIONS
Duodenal stent placement resulted in prompt relief of malignant gastric outlet obstruction and improved GOOSS scores. (


BACKGROUND
NCT00991614.).
Digestive Endoscopy Unit, Catholic University, Rome, Italy.
Andrea
A
Tringali
Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, the Netherlands.
Paul
P
Didden
Digestive Endoscopy Unit, IRCCS Istituto Clinico Humanitas, Milan, Italy.
Alessandro
A
Repici
Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, the Netherlands.
Manon
M
Spaander
Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, New South Wales, Australia.
Michael J
MJ
Bourke
Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, New South Wales, Australia.
Stephen J
SJ
Williams
Department of Hepatogastroenterology, IKEM, Prague, Czech Republic.
Julius
J
Spicak
Department of Hepatogastroenterology, IKEM, Prague, Czech Republic.
Pavel
P
Drastich
Digestive Endoscopy Unit, Catholic University, Rome, Italy.
Massimiliano
M
Mutignani
Digestive Endoscopy Unit, Catholic University, Rome, Italy.
Vincenzo
V
Perri
Endoscopy Unit, Centre Hospitalier de l'Université de Montreal (CHUM), Hôpital Saint-Luc, Montréal Québec, Canada.
André
A
Roy
MED Institute, Inc, West Lafayette, Indiana, USA.
Krystal
K
Johnston
Digestive Endoscopy Unit, Catholic University, Rome, Italy.
Guido
G
Costamagna
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004067:Digestive System Neoplasms / Q000150:complications*; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects; D005260:Female; D017219:Gastric Outlet Obstruction / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D011446:Prospective Studies; D012720:Severity of Illness Index; D015607:Stents / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome
GJJ; GOOSS; gastric outlet obstruction scoring system; gastrojejunostomy