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Stent under‐expansion on the procedure day, a predictive factor for poor oral intake after metallic stenting for gastric outlet obstruction
Author(s) -
Hori Yasuki,
Naitoh Itaru,
Ban Tesshin,
Narita Kei,
Nakazawa Takahiro,
Hayashi Kazuki,
Miyabe Katsuyuki,
Shimizu Shuya,
Kondo Hiromu,
Nishi Yuji,
Yoshida Michihiro,
Umemura Shuichiro,
Kato Akihisa,
Yamada Tomonori,
Ando Tomoaki,
Joh Takashi
Publication year - 2015
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12933
Subject(s) - medicine , gastric outlet obstruction , odds ratio , stent , confidence interval , referral , self expandable metallic stent , surgery , multivariate analysis , retrospective cohort study , family medicine
Background and Aim Self‐expandable metallic stents ( SEMS ) have been widely accepted as palliation therapy for malignant gastric outlet obstruction ( GOO ). However, the factors predictive of poor oral intake after SEMS placement have not been elucidated sufficiently. We aimed to clarify both the patient and stent‐related predictive factors. Methods We retrospectively reviewed 126 consecutive patients who underwent uncovered SEMS placement for malignant GOO between A pril 2010 and M arch 2013 at a university hospital and two tertiary care referral centers. Results Technical success of SEMS placement was achieved in all 126 (100%) patients. Improved oral intake was observed in 111 (88.1%) patients. A K arnofsky performance status ≤ 40 (odds ratio [ OR ], 1.19; 95% confidence interval [ CI ], 1.02–1.28; P = 0.041), peritoneal dissemination ( OR , 1.20; 95% CI, 1.01–1.26; P = 0.038), and under‐expansion of the SEMS on the procedure day ( OR , 1.55; 95% CI , 1.26–1.62; P < 0.001) were independent predictive factors for poor improvement on the GOO scoring system, according to multivariate analysis. Conclusions SEMS under‐expansion was a stent related, while poor performance status and peritoneal dissemination were patient related, predictive factors for poor oral intake after SEMS placement for malignant GOO .