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Outcome of self‐expandable metallic stent deployment in patients with malignant gastroduodenal outlet obstruction and Niti‐S and WallFlex comparison: a multicenter retrospective clinical study
Author(s) -
Kato Hironari,
Kawamoto Hirofumi,
Matsumoto Kazuya,
Moriyama Ichiro,
Kamada Hideki,
Tsutsumi Koichiro,
Goto Daisuke,
Fukuba Nobuhiko,
Kato Kiyohito,
Sonoyama Hiroki,
Isomoto Hajime,
Okada Hiroyuki
Publication year - 2016
Publication title -
journal of digestive diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 51
eISSN - 1751-2980
pISSN - 1751-2972
DOI - 10.1111/1751-2980.12377
Subject(s) - medicine , stent , gastric outlet obstruction , self expandable metallic stent , surgery , complication , adverse effect , retrospective cohort study , clinical trial , radiology
Objectives Several studies report on the outcomes of self‐expandable metallic stents (SEMSs) deployment for malignant gastric outlet obstruction (GOO). However, data was mostly based on the analysis of single‐center studies including only a small number of patients. This study aimed to evaluate clinical outcomes after the deployment of SEMS in patients with malignant GOO and to compare the clinical outcomes of two metallic stents with different designs. Methods Altogether 125 consecutive patients from five institutions were included. Clinical outcomes were evaluated according to technical success, clinical success, stent patency period, survival period and complications. A comparison of clinical outcomes between Niti‐S pyloric/duodenal and WallFlex duodenal stents was also undertaken. Results Rates for clinical and technical success were 100% and 92.0%, respectively. The median stent patency and survival periods were 72.0 days (range 3–775 days) and 75.0 days (range 3–775 days), respectively. The rate of overall adverse events was 28.8%. The rate of stent dysfunction was 16.8%, and that of adverse events, except stent dysfunction was 12.0%. Massive bleeding occurred in two patients as a late complication. The clinical success rate for Niti‐S stent was significantly higher than that for WallFlex stent (96.2% vs 84.8%, P = 0.023). Conclusions We successfully deployed a SEMS in malignant GOO. The selection of a SEMS with a lower axial force may be important for patients to resume the oral food intake. Additionally, consideration must be given to the appropriate management of fatal bleeding as a late complication.