Comparison of ultraflex and niti-s stents for palliation of unresectable malignant gastroduodenal obstruction.

AIM

Self-expandable metallic stents are widely used for palliation of malignant gastric outlet obstruction (GOO), but clinical outcomes of different stents have not been compared. Here, we compared outcomes in patients with a GOO receiving either an Ultraflex (UF) or a Niti-S (NS) stent.

METHODS

Prospective outcomes in 53 patients receiving palliative placement of an NS stent for symptomatic GOO over a 3-year period were compared with those obtained retrospectively in 31 patients receiving a UF stent in a previous 5-year period. Main outcome measurement was between-group comparison of clinical outcome, complications, and reintervention.

RESULTS

Baseline characteristics between the groups were comparable. No difference in technical or clinical success rate was observed. Median procedure time for NS placement was shorter than for UF (15 vs 40 min; P < 0.0001). Complications were more frequent with NS than with UF placement, albeit without statistical significance (16% vs 25%). Although two severe complications occurred in each group, neither was stent related in the NS group. Reintervention was more frequent in the NS group (3% vs 21%; P = 0.0485). Median survival time was 53 versus 88 days for UF versus NS stents, respectively.

CONCLUSION

Although no significant difference was seen with regard to feasibility, reintervention was less frequent with UF stents than with NS stents. However, UF stents require much more procedure time, and a complicated and difficult placement procedure. These observations suggest that although NS stents placed using a through-the-scope technique may be more patient friendly than UF stents, further optimization of through-the-scope stents is still required. Further prospective comparison of NS and UF stents in GOO treatment is warranted.