一种高柔韧性十二指肠支架缓解胃出口梗阻的疗效
Efficacy of a higher-flexibility duodenal stent for palliation of gastric outlet obstruction.
作者信息
Kapteijn Noa Eveline Adriana, Zellenrath Pauline A, Siersema Peter, Reijm Agnes N, Van Driel Lydi, de Jonge Pieter J F, Lammers Wim J, Honing Judith, Spaander Manon C W
机构信息
Gastroenterology and Hepatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands.
Gastroenterology and Hepatology, Reinier de Graaf Gasthuis, Rotterdam, Netherlands.
出版信息
Endosc Int Open. 2025 Mar 14;13:a25399270. doi: 10.1055/a-2539-9270. eCollection 2025.
BACKGROUND AND STUDY AIMS
Duodenal self-expandable metallic stent (SEMS) placement is a common palliative treatment for malignant gastric outlet obstruction symptoms (GOOS). The higher flexibility of the WallFlex Duodenal Soft stent aims to ease stent placement and reduce adverse events (AE). This descriptive study compared the WallFlex Soft stent with other duodenal SEMS designs with regard to efficacy and safety.
PATIENTS AND METHODS
Patients receiving the WallFlex Duodenal Soft stent as first-line treatment for GOOS were included in a prospective cohort (2019-2023). A retrospective cohort (1998-2019) with patients treated with other duodenal SEMS designs as first-line treatment for GOOS was used for comparison.
RESULTS
In the prospective cohort, 11 patients were treated with the WallFlex Duodenal Soft, achieving 100% technical and 82% clinical success rates. The retrospective cohort of 147 patients with various types of duodenal SEMS showed 97% technical and 86% clinical success. For the WallFlex Duodenal Soft vs. the other duodenal SEMS, the overall survival was 101 vs. 82 days and median symptom-free survival was 83 vs. 28 days. AE rates were 18% vs. 28%, respectively.
CONCLUSIONS
The WallFlex Duodenal Soft stent effectively treats GOOS in palliative patients and seems to be associated with longer symptom-free survival and lower AE rates compared with previous duodenal SEMS designs.
背景与研究目的
十二指肠自膨式金属支架（SEMS）置入术是治疗恶性胃出口梗阻症状（GOOS）的一种常见姑息治疗方法。WallFlex十二指肠软支架具有更高的柔韧性，旨在便于支架置入并减少不良事件（AE）。本描述性研究比较了WallFlex软支架与其他十二指肠SEMS设计在疗效和安全性方面的差异。
患者与方法
将接受WallFlex十二指肠软支架作为GOOS一线治疗的患者纳入前瞻性队列研究（2019 - 2023年）。使用一个回顾性队列研究（1998 - 2019年）进行比较，该队列中的患者接受其他十二指肠SEMS设计作为GOOS的一线治疗。
结果
在前瞻性队列中，11例患者接受了WallFlex十二指肠软支架治疗，技术成功率达100%，临床成功率达82%。147例接受各种类型十二指肠SEMS治疗的回顾性队列患者的技术成功率为97%，临床成功率为86%。对于WallFlex十二指肠软支架与其他十二指肠SEMS，总生存期分别为101天和82天，中位无症状生存期分别为83天和28天。不良事件发生率分别为18%和28%。
结论
WallFlex十二指肠软支架能有效治疗姑息患者的GOOS，与以往十二指肠SEMS设计相比，似乎与更长的无症状生存期和更低的不良事件发生率相关。
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