Palliation in patients with malignant gastric outlet obstruction with a newly designed enteral stent: a multicenter study.

BACKGROUND

Through-the-scope (TTS) stents facilitate palliative enteral stent placement. However, most TTS stents are braided, a characteristic that has been associated with significant foreshortening and relatively frequent migration.

OBJECTIVES

To evaluate clinical experience with a new woven enteral stent in the treatment of gastric outlet obstruction.

DESIGN

From January 2005 to August 2006, patients with unresectable malignant gastric outlet obstruction were offered stent placement with a new woven stent.

SETTING

Three referral hospitals in Japan.

PATIENTS

Thirty-seven consecutive patients with malignant gastric outlet obstruction.

INTERVENTIONS

A newly designed enteral stent was placed by using the TTS placement technique.

MAIN OUTCOME MEASUREMENTS

Palliation efficacy and safety of the new stents.

RESULTS

Stent placement was successful in 36 of 37 patients (technical success, 97%). Thirty-four patients were able to tolerate oral intake without obstructive symptoms (clinical success, 94.4%). Complications occurred in 16.2% of patients, comprising 2 cases of primary stent dysfunction, 1 perforation, 1 GI bleeding, 1 stent obstruction, and 1 biliary stent dysfunction. No migration was seen during the median follow-up period of 68 days.

LIMITATIONS

Small sample size and relatively brief follow-up.

CONCLUSIONS

A newly developed enteral stent with higher flexibility and less foreshortening offers comparable clinical outcome to existing stents and a lower frequency of complications, including migration.