title: Factors That Affect Stent-Related Complications in Patients with Malignant Obstruction of the Esophagus or Gastric Cardia.
abstract: OBJECTIVE
  Self-expandable metallic stent (SEMS) placement is effective for dysphagia that results from malignant obstruction of the esophagus or gastric cardia; however, stent-related complications may be life-threatening. Thus, the goal of this study was to identify risk factors associated with complications following esophageal stenting.
  
  
  METHODS
  Of the 71 patients who underwent SEMS placement for dysphagia as a result of malignant stricture of the esophagus or gastric cardia, 53 patients with squamous cell carcinoma or adenocarcinoma, without previous SEMS placement, without a fistula, and without recurrent tumor after surgery were retrospectively identified. The occurrence of stent-related complications was used as an endpoint.
  
  
  RESULTS
  Stent-related complications were identified in 26 patients (49.1%), and major complications occurred in 14 patients (26.4%). The use of an Ultraflex stent (odds ratio [OR], 6.81; 95% confidence interval [CI], 1.54 to 30.00; p=0.011) and prior chemotherapy (OR, 6.13; 95% CI, 1.46 to 25.70; p=0.013) were significantly associated with stent-related complications. Moreover, the use of an Ultraflex stent (OR, 19.60; 95% CI, 2.26 to 170.00; p=0.007) and prior radiation (OR, 25.70; 95% CI, 2.37 to 280.00; p=0.008) significantly increased the risk of major complications.
  
  
  CONCLUSIONS
  The use of an Ultraflex stent and prior radiation and/or chemotherapy may represent risk factors for complications following esophageal SEMS placement.
authors.affiliation: Department of Gastroenterology, Gifu Prefectural Tajimi Hospital, Tajimi, Japan.
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Iwasaki
authors.affiliation: Department of Gastroenterology, Gifu Prefectural Tajimi Hospital, Tajimi, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Mizushima
authors.affiliation: Department of Gastroenterology, Gifu Prefectural Tajimi Hospital, Tajimi, Japan.
authors.forename: Yuta
authors.initials: Y
authors.lastname: Suzuki
authors.affiliation: Department of Gastroenterology, Gifu Prefectural Tajimi Hospital, Tajimi, Japan.
authors.forename: Shigeki
authors.initials: S
authors.lastname: Fukusada
authors.affiliation: Department of Gastroenterology, Gifu Prefectural Tajimi Hospital, Tajimi, Japan.
authors.forename: Kenta
authors.initials: K
authors.lastname: Kachi
authors.affiliation: Department of Gastroenterology, Gifu Prefectural Tajimi Hospital, Tajimi, Japan.
authors.forename: Takanori
authors.initials: T
authors.lastname: Ozeki
authors.affiliation: Department of Gastroenterology, Gifu Prefectural Tajimi Hospital, Tajimi, Japan.
authors.forename: Kaiki
authors.initials: K
authors.lastname: Anbe
authors.affiliation: Department of Gastroenterology, Gifu Prefectural Tajimi Hospital, Tajimi, Japan.
authors.forename: Hironobu
authors.initials: H
authors.lastname: Tsukamoto
authors.affiliation: Department of Gastroenterology, Gifu Prefectural Tajimi Hospital, Tajimi, Japan.
authors.forename: Fumihiro
authors.initials: F
authors.lastname: Okumura
authors.affiliation: Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Joh
authors.affiliation: Department of Gastroenterology, Gifu Prefectural Tajimi Hospital, Tajimi, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Sano
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000601:surgery*; D002299:Cardia / Q000601:surgery*; D059248:Chemoradiotherapy; D003251:Constriction, Pathologic; D003680:Deglutition Disorders / Q000209:etiology / Q000601:surgery*; D004937:Esophageal Fistula / Q000453:epidemiology; D004938:Esophageal Neoplasms / Q000150:complications / Q000601:surgery*; D004939:Esophageal Perforation / Q000453:epidemiology; D004940:Esophageal Stenosis / Q000209:etiology / Q000601:surgery*; D004945:Esophagoscopy; D005260:Female; D005334:Fever / Q000453:epidemiology; D005773:Gastroscopy; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010166:Palliative Care; D011015:Pneumonia, Aspiration / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology*; D019106:Postoperative Hemorrhage / Q000453:epidemiology; D011475:Prosthesis Failure; D011878:Radiotherapy; D012189:Retrospective Studies; D000069322:Self Expandable Metallic Stents; D013272:Stomach Diseases / Q000209:etiology / Q000601:surgery*
chemical_list: D000970:Antineoplastic Agents
keywords: Chemotherapy; Complication; Esophageal stent; Radiation; Risk factors