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01-05-2011

Self-expandable metallic stent placement for malignant obstruction in patients with locally recurrent gastric cancer

Authors: Jaihwan Kim, Il Ju Choi, Chan Gyoo Kim, Jong Yeul Lee, Soo-Jeong Cho, Sook Ryun Park, Jun Ho Lee, Keun Won Ryu, Young-Woo Kim, Young-Iee Park

Published in: Surgical Endoscopy | Issue 5/2011

Abstract

Background

Self-expandable metallic stents (SEMSs) provide effective palliation for inoperable malignant gastric outlet obstruction (GOO). The objective of this study was to evaluate the effectiveness of SEMSs in patients with recurrent gastric cancer after radical gastrectomy.

Methods

We retrospectively analyzed data from patients with gastric cancer who underwent endoscopic SEMS placement. The patients had obstructive symptoms due to recurrent gastric cancer after curative-intent subtotal or total gastrectomies. Technical and clinical success rates of stent placement were evaluated and clinical outcomes were compared according to operation types.

Results

A total of 15 patients underwent total gastrectomies with esophagojejunostomies and Roux-en-Y reconstructions, 8 underwent subtotal gastrectomies with Billroth I reconstructions, and 12 underwent subtotal gastrectomies with Billroth II reconstructions. Four patients in the Billroth II group received stents in afferent and efferent loops, so a total of 39 stents were placed. Technical success was achieved with 92% (36/39) of stents, and clinical success occurred with 90% (35/39) of stents, with no significant differences among surgery groups or between stent types (covered vs. uncovered). The GOO score (preprocedure: 0.45 ± 0.62) increased by 1 week (2.06 ± 0.51, p < 0.001) and was maintained up to 1 month (1.71 ± 1.15, p < 0.001 compared with initial score). Complications occurred with 17 of 39 stents (44%) and included 2 perforations, 3 migrations, and 12 restenoses. Median stent patency duration was 10.7 weeks and median survival was 21.3 weeks; these did not significantly differ by surgery group (p = 0.25 and 0.93, respectively) or stent type (covered vs. uncovered, p = 0.51 and 0.96, respectively).

Conclusion

Endoscopic SEMS placement for obstruction due to recurrent cancer after total or subtotal gastrectomy is feasible and provides effective short-term palliation, independent of the type of surgical procedure or stent (covered vs. uncovered) used.

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Title: Self-expandable metallic stent placement for malignant obstruction in patients with locally recurrent gastric cancer
Authors: Jaihwan Kim
Il Ju Choi
Chan Gyoo Kim
Jong Yeul Lee
Soo-Jeong Cho
Sook Ryun Park
Jun Ho Lee
Keun Won Ryu
Young-Woo Kim
Young-Iee Park
Publication date: 01-05-2011
Publisher: Springer-Verlag
Published in: Surgical Endoscopy / Issue 5/2011
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-010-1426-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Self-expandable metallic stent placement for malignant obstruction in patients with locally recurrent gastric cancer

Abstract

Background

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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