Clinical outcomes of re-stenting in patients with stent malfunction in malignant gastric outlet obstruction.

Jin, Eun; Kim, Sang; Seo, Ji; Im, Jong; Kim, Joo; Jung, Hyun; Jin, Eun Hyo; Kim, Sang Gyun; Seo, Ji Yeon; Im, Jong Pil; Kim, Joo Sung; Jung, Hyun Chae

<bold>Background and Aims: </bold>Self-expanding metal stents (SEMS) have been used for the palliative treatment of malignant gastric outlet obstruction (GOO). The aim of this study was to evaluate the clinical outcomes of salvage SEMS for stent malfunction and to identify the prognostic factors for a longer patency.<bold>Methods: </bold>A total of 108 patients who underwent a secondary salvage SEMS placement for a primary stent malfunction were retrospectively reviewed at the Seoul National University Hospital between August 2004 and May 2013. The duration of patency for salvage SEMS was defined as the time between salvage SEMS placement and the recurrence of obstructive symptoms that were confirmed either endoscopically or radiologically.<bold>Results: </bold>The technical and clinical success rates for salvage SEMS were 100 and 82.4% (95% confidence interval [CI] 74.0-89.0), respectively. A salvage SEMS malfunction occurred in 29 (26.9%) of the 108 patients. The median duration of patency for salvage SEMS was 59.5 days (range 3-928, 95% CI 73.7-118.3). Longer SEMS patencies of more than 60 days were significantly associated with palliative chemotherapy (odds ratio = 2.539, 95% CI 1.031-6.252, p = .043). For salvage SEMS, covered-uncovered stents had a longer patency duration, as compared with other combinations of primary and salvage stent types.<bold>Conclusions: </bold>Longer patency durations for salvage SEMS were associated with palliative chemotherapy after salvage SEMS insertion. Salvage SEMS could be a feasible and effective treatment for primary stent malfunction in malignant GOO.

SURGICAL stents; STOMACH cancer; PALLIATIVE treatment; CANCER chemotherapy; SALVAGE therapy; COMPARATIVE studies; RESEARCH methodology; MEDICAL cooperation; COMPLICATIONS of prosthesis; REOPERATION; RESEARCH; EVALUATION research; TREATMENT effectiveness; RETROSPECTIVE studies; DIGESTIVE organs; GASTRIC outlet obstruction; DISEASE complications; TUMORS

Surgical Endoscopy & Other Interventional Techniques, 2016, Vol 30, Issue 4, p1372

1866-6817

Academic Journal

10.1007/s00464-015-4338-z