Korean J Radiol.  2012 Feb;13(Suppl 1):S98-S103. 10.3348/kjr.2012.13.S1.S98.

Palliation of Malignant Upper Gastrointestinal Obstruction with Self-Expandable Metal Stent

• Morikawa S
• Suzuki A
• Nakase K
• Yasuda K

• KMID: 1372874
• DOI: http://doi.org/10.3348/kjr.2012.13.S1.S98

Abstract

OBJECTIVE
To assess the technical success, ability to eat, complications and clinical outcomes of patients with self-expandable metal stent (SEMS) placed for malignant upper gastrointestinal (GI) obstruction.
MATERIALS AND METHODS
Data was collected retrospectively on patients who underwent SEMS placement for palliation of malignant upper GI obstruction by reviewing hospital charts from June 1998 to May 2011. Main outcome measurements were technical success, gastric outlet obstruction scoring system (GOOSS) score before and after treatment, complications, and survival.
RESULTS
A total of 82 patients underwent SEMS placement with malignant upper GI obstruction. The initial SEMS placement was successful in 77 patients (93.9%). The mean GOOSS score was 0.56 before stenting and 1.92 (p < 0.001) after treatment. Complications arose in 12 patients (14.6%): stent migration in 1 patient (1.2%), perforation in 1 (1.2%), and obstruction of stent due to tumor ingrowth in 10 (12.2%). The median survival time after stenting was 52 days (6-445).
CONCLUSION
SEMS placement is an effective and safe treatment for palliation of malignant upper GI obstruction. It provides lasting relief in dysphagia and improves the QOL of patients.

Keyword

SEMS; Palliation of malignant obstruction; Upper gastrointestinal obstruction; GOO

MeSH Terms

Adult
Aged
Aged, 80 and over
Deglutition Disorders/physiopathology/prevention & control
Equipment Design
Female
Humans
Intestinal Neoplasms/physiopathology/*surgery
Intestinal Obstruction/physiopathology/*surgery
Male
Metals
Middle Aged
*Palliative Care
Postoperative Complications
Retrospective Studies
*Stents
Survival Rate
Treatment Outcome
*Upper Gastrointestinal Tract

Figure

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  Fig. 1 Complications according to location of obstruction and type of SEMS. EGJ = esophago-gastro junction

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  Fig. 2 Survival of all patients after SEMS placement. SEMS = self-expandable metal stent

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  Fig. 3 Survival depending on type of stent. SEMS = self-expandable metal stent

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