TY - JOUR
T1 - Endoscopic treatment of malignant gastric and duodenal strictures
T2 - A prospective, multicenter study
AU - Tringali, Andrea
AU - Didden, Paul
AU - Repici, Alessandro
AU - Spaander, Manon
AU - Bourke, Michael J.
AU - Williams, Stephen J.
AU - Spicak, Julius
AU - Drastich, Pavel
AU - Mutignani, Massimiliano
AU - Perri, Vincenzo
AU - Roy, André
AU - Johnston, Krystal
AU - Costamagna, Guido
PY - 2014/1
Y1 - 2014/1
N2 - Background Malignant gastric outlet obstruction is often treated by stent placement. Objective To investigate the outcomes of stent placement in the palliative treatment of malignant neoplasms. Design Prospective, observational, multicenter registry. Setting Six tertiary care centers in 5 countries. Patients A total of 108 adult patients with malignant gastric outlet obstruction. Interventions Placement of an uncovered, self-expandable, metal duodenal stent. Main Outcome Measurements The primary endpoint was stent patency at 14 days after stent implantation. Secondary endpoints included stent patency at 1, 2, 3, and 6 months, gastric outlet obstruction scoring system (GOOSS) scores at 14 days and 1, 2, 3, and 6 months after stent deployment, technical success, adverse events, and patient survival (ie, confirmed duration of the implant). Results Technical success was achieved in 99.1% of stent placements. Stent patency at 14 days was 94.6%. Kaplan-Meier estimates of stent patency were 92.9% at 1 month, 86.2% at 2 months, 81.9% at 3 months, and 63.4% at 6 months. At 14 days, GOOSS scores increased by a median of 1 point. The overall GI adverse event rate was 32.4%; however, the stent-related adverse event rate was 19.4%. The median implant duration was 47 days (range 0-195 days). Limitations Observational study, no control group. Conclusions Duodenal stent placement resulted in prompt relief of malignant gastric outlet obstruction and improved GOOSS scores. (Clinical trial registration number: NCT00991614.).
AB - Background Malignant gastric outlet obstruction is often treated by stent placement. Objective To investigate the outcomes of stent placement in the palliative treatment of malignant neoplasms. Design Prospective, observational, multicenter registry. Setting Six tertiary care centers in 5 countries. Patients A total of 108 adult patients with malignant gastric outlet obstruction. Interventions Placement of an uncovered, self-expandable, metal duodenal stent. Main Outcome Measurements The primary endpoint was stent patency at 14 days after stent implantation. Secondary endpoints included stent patency at 1, 2, 3, and 6 months, gastric outlet obstruction scoring system (GOOSS) scores at 14 days and 1, 2, 3, and 6 months after stent deployment, technical success, adverse events, and patient survival (ie, confirmed duration of the implant). Results Technical success was achieved in 99.1% of stent placements. Stent patency at 14 days was 94.6%. Kaplan-Meier estimates of stent patency were 92.9% at 1 month, 86.2% at 2 months, 81.9% at 3 months, and 63.4% at 6 months. At 14 days, GOOSS scores increased by a median of 1 point. The overall GI adverse event rate was 32.4%; however, the stent-related adverse event rate was 19.4%. The median implant duration was 47 days (range 0-195 days). Limitations Observational study, no control group. Conclusions Duodenal stent placement resulted in prompt relief of malignant gastric outlet obstruction and improved GOOSS scores. (Clinical trial registration number: NCT00991614.).
KW - gastric outlet obstruction scoring system
KW - gastrojejunostomy
KW - GJJ
KW - GOOSS
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U2 - 10.1016/j.gie.2013.06.032
DO - 10.1016/j.gie.2013.06.032
M3 - Article
C2 - 23932009
AN - SCOPUS:84890481478
VL - 79
SP - 66
EP - 75
JO - Gastrointestinal Endoscopy
JF - Gastrointestinal Endoscopy
SN - 0016-5107
IS - 1
ER -