Predictors of self-expanding metallic stent dysfunction in malignant gastric outlet obstruction
L S Suder-Castro, M E Ramírez-Solís, A I Hernández-Guerrero, J G de la Mora-Levy, J O Alonso-Lárraga, A H Hernández-Lara, L S Suder-Castro, M E Ramírez-Solís, A I Hernández-Guerrero, J G de la Mora-Levy, J O Alonso-Lárraga, A H Hernández-Lara
Abstract
Introduction and objectives: Self-expanding metallic stents (SEMS) are the ideal treatment for malignant gastric outlet obstruction (MGOO) in patients with a short life expectancy, but stent dysfunction is frequent. The primary aim of our study was to identify the predictive factors of SEMS dysfunction in MGOO and the secondary aim was to determine the technical success, clinical success, and nutritional impact after SEMS placement.
Material and methods: A retrospective, longitudinal study was conducted at the gastrointestinal endoscopy department of the Instituto Nacional de Cancerología in Mexico City. Patients diagnosed with MGOO that underwent SEMS placement within the time frame of January 2015 to May 2018 were included. We utilized the gastric outlet obstruction scoring system (GOOSS) to determine clinical success and SEMS dysfunction.
Results: The study included 43 patients, technical success was 97.7% (n=42), and clinical success was 88.3% (n=38). SEMS dysfunction presented in 30.2% (n=13) of the patients, occurring in<6 months after placement in 53.8% (n=7) of them. In the univariate analysis, the histologic subtype, diffuse gastric adenocarcinoma (p=0.02) and the use of uncovered SEMS (p=0.02) were the variables associated with dysfunction. Albumin levels and body mass index did not increase after SEMS placement. Medical follow-up was a mean 5.8 months (1-24 months).
Conclusions: SEMS demonstrated adequate technical and clinical efficacy in the treatment of MGOO. SEMS dysfunction was frequent and diffuse type gastric cancer and uncovered SEMS appeared to be dysfunction predictors.
Keywords: Gastric outlet obstruction scoring system; Malignant gastric outlet obstruction; Obstrucción de salida gástrica maligna; Self-expanding metallic stent; Sistema de puntuación de obstrucción de salida gástrica; Stent metálico auto-expandible.
Copyright © 2020 Asociación Mexicana de Gastroenterología. Publicado por Masson Doyma México S.A. All rights reserved.
Source: PubMed