Enteral self-expandable metal stent for malignant luminal obstruction of the upper and lower gastrointestinal tract: a prospective multicentric study

J Clin Gastroenterol. 2008 Apr;42(4):389-94. doi: 10.1097/MCG.0b013e318033d30a.

Abstract

Background: Self-expanding metal stents (SEMSs) are used to treat malignant stenosis of the gastrointestinal (GI) tract, as a safe, feasible, and minimally invasive option for reestablishing luminal patency. However, the literature offers scant prospective data on the clinical outcome of these patients.

Aim: To assess the technical success, complications, and clinical outcomes of patients with a SEMS placed for malignant upper and lower GI obstruction.

Patients and methods: A cohort of 110 patients with clinical symptoms related to malignant stenosis of the upper and lower GI tract were prospectively enrolled and SEMSs were placed endoscopically in 9 endoscopy centers. The patients were followed up and survival, oral intake, stool canalization, and late complications were recorded on days 30, 90, and 180.

Results: Overall, 110 patients, 38 (34.5%) with upper and 72 (65.5%) with lower GI obstruction were examined. The procedure was successful in 102 (92.7%). There were 5 early complications (<96 h) (4.5%). Late complications (>96 h) occurred in 6 patients (6.3%). Median survival after stenting was 90 days (q1 30; q3 120). Placing the SEMS enabled 79.4%, 90.9%, and 100% of the patients to resume an oral diet at 30, 90, and 180 days, respectively. All patients had stool canalization until death.

Conclusions: Endoscopic stenting is an effective and safe procedure for malignant luminal obstruction of the GI tract, with good clinical outcomes in patients whose survival is unfortunately short.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Endoscopy, Gastrointestinal / methods*
  • Female
  • Follow-Up Studies
  • Gastrointestinal Neoplasms / complications*
  • Gastrointestinal Neoplasms / diagnosis
  • Gastrointestinal Neoplasms / surgery
  • Humans
  • Intestinal Obstruction / diagnosis
  • Intestinal Obstruction / etiology
  • Intestinal Obstruction / surgery*
  • Italy
  • Male
  • Metals*
  • Middle Aged
  • Prospective Studies
  • Prosthesis Design
  • Prosthesis Implantation / instrumentation*
  • Stents*
  • Treatment Outcome

Substances

  • Metals