Fung Brian M, Kadera Brian E, Tabibian James H
Department of Medicine, Olive View-UCLA Medical Center, Sylmar, California, USA.
David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
Gastrointest Tumors. 2021 Jan;8(1):1-7. doi: 10.1159/000510350. Epub 2020 Oct 9.
Self-expandable metal stents (SEMSs) are frequently utilized for palliation of malignant gastric and/or duodenal outlet obstruction (GDOO). Re-establishing luminal patency with accurate SEMS positioning while limiting migration and adjacent tissue injury is an important technical consideration and aim. The duodenal HANAROSTENT was introduced in the USA in 2019 and developed with these challenges in mind. As the first center in the USA to deploy the duo-denal HANAROSTENT in clinical practice, we herein examine our early experience with its use. Specifically, we describe 7 consecutive cases of malignant GDOO in which a duodenal HANAROSTENT was placed for on-label use, defined as palliative treatment of malignant gastric and/or duodenal obstruction. All stents were 22 mm in diameter, with 5 being 90 mm and 2 being 120 mm in length. Technical and clinical success with duodenal HANAROSTENT placement were achieved in all 7 cases (100%). In no case was stent adjustment required post-deployment. There were no stent-related adverse events, and no subsequent endoscopic procedures were necessary in any of the patients during a mean follow-up of 5 months (range 1-12 months). In summary, the duodenal HANAROSTENT appears to perform well and be a promising alternative to other available duodenal SEMSs. As experience in the USA with this newly introduced duodenal SEMS grows, multicenter prospective data should be collected to better establish its relative safety and efficacy.
自膨式金属支架(SEMSs)常用于缓解恶性胃和/或十二指肠出口梗阻(GDOO)。在准确放置SEMS以重建管腔通畅性的同时,限制支架移位和减少对邻近组织的损伤是一项重要的技术考量和目标。十二指肠HANAROSTENT于2019年在美国推出,其研发便是考虑到了这些挑战。作为美国首个在临床实践中部署十二指肠HANAROSTENT的中心,我们在此审视了我们使用该支架的早期经验。具体而言,我们描述了7例连续的恶性GDOO病例,这些病例中放置十二指肠HANAROSTENT用于标签上规定的用途,即对恶性胃和/或十二指肠梗阻进行姑息治疗。所有支架直径均为22毫米,其中5个长度为90毫米,2个长度为120毫米。所有7例(100%)十二指肠HANAROSTENT放置均取得了技术和临床成功。部署后均无需调整支架。无支架相关不良事件发生,在平均5个月(范围1 - 12个月)的随访期间,所有患者均无需后续内镜检查。总之,十二指肠HANAROSTENT似乎表现良好,是其他现有十二指肠SEMS的一个有前景的替代方案。随着美国对这种新引入的十二指肠SEMS的经验不断积累,应收集多中心前瞻性数据,以更好地确定其相对安全性和有效性。