Shi Ding, Wu Dong, Liu Yongpan, Ji Feng, Bao Yinsu
Department of Gastroenterology, Huamei Hospital, University of Chinese Academy of Sciences, Ningbo 315010, China.
Department of Gastroenterology, The First People's Hospital of Yuhang District, Hangzhou 311100, China.
Gastroenterol Res Pract. 2019 Jul 1;2019:8093091. doi: 10.1155/2019/8093091. eCollection 2019.
This study is aimed at evaluating the efficacy and safety of the big end double-layer uncovered self-expanding metal stents (SEMS) for the treatment of gastric outlet obstruction (GOO) caused by distal stomach cancer.
Seventy three patients receiving big end double-layer uncovered SEMS for the treatment of GOO caused by distal gastric cancer will be included in this multicenter prospective clinical trial. The main outcome measures included the functional outcome, the complications, the reinterventional rates, the average treatment charges, and the mean survival time. Monthly telephone calls were needed to assess the food intake until the patients died.
The technical and the clinical success rates were 98.6%. The stent obstruction caused by tumor ingrowth was observed in one patient (1.4%). The incidence of food impaction was 2.9% (2/70) and the reinterventional rate was 4.3% (3/70). However, stent migration and obstruction caused by overgrowth were not observed. No perforation and severe bleeding were observed. The median cost of endoscopic stenting and total hospitalization (including reinterventions) for the big end double-layer uncovered SEMS in this study was $2945 and $3408, respectively. The mean survival time was 212.5 days.
The placement of big end double-layer uncovered SEMS is a safe and effective modality and has the potential to be one of the options for the treatment of GOO caused by the distal gastric cancer.
本研究旨在评估大口径双层无覆膜自膨式金属支架（SEMS）治疗远端胃癌所致胃出口梗阻（GOO）的疗效和安全性。
本多中心前瞻性临床试验将纳入73例接受大口径双层无覆膜SEMS治疗远端胃癌所致GOO的患者。主要观察指标包括功能结局、并发症、再次干预率、平均治疗费用和平均生存时间。在患者死亡前，每月需通过电话评估食物摄入量。
技术成功率和临床成功率为98.6%。1例患者（1.4%）出现肿瘤长入导致的支架梗阻。食物嵌塞发生率为2.9%（2/70），再次干预率为4.3%（3/70）。然而，未观察到支架移位和过度生长导致的梗阻。未观察到穿孔和严重出血。本研究中，大口径双层无覆膜SEMS的内镜下支架置入中位费用和总住院费用（包括再次干预）分别为2945美元和3408美元。平均生存时间为212.5天。
大口径双层无覆膜SEMS置入是一种安全有效的治疗方式，有可能成为治疗远端胃癌所致GOO的选择之一。
