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Kim M, Rai M, Teshima C. Interventional Endoscopy for Palliation of Luminal Gastrointestinal Obstructions in Management of Cancer: Practical Guide for Oncologists. J Clin Med 2022; 11:jcm11061712. [PMID: 35330037 PMCID: PMC8953341 DOI: 10.3390/jcm11061712] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/08/2022] [Accepted: 03/13/2022] [Indexed: 12/22/2022] Open
Abstract
Self-expanding metal stents placed during endoscopy are increasingly the first-line treatment for luminal obstruction caused by esophageal, gastroduodenal, and colorectal malignancies in patients who are not candidates for definitive surgical resection. In this review, we provide a practical guide for clinicians to optimise patient and procedure selection for endoscopic stenting in malignant gastrointestinal obstructions. The role of endoscopic stenting in each of the major anatomical systems (esophageal, gastroduodenal, and colorectal) is presented with regard to pre-procedural patient evaluation, procedural techniques, clinical outcomes, and potential complications, as well as post-procedure aftercare.
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Dai Y, Li C, Xie Y, Liu X, Zhang J, Zhou J, Pan X, Yang S. Interventions for dysphagia in oesophageal cancer. Cochrane Database Syst Rev 2014; 2014:CD005048. [PMID: 25354795 PMCID: PMC8106614 DOI: 10.1002/14651858.cd005048.pub4] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Most patients with oesophageal and gastro-oesophageal carcinoma are diagnosed at an advanced stage and require palliative intervention. Although there are many kinds of interventions, the optimal one for the palliation of dysphagia remains unclear. This review updates the previous version published in 2009. OBJECTIVES The aim of this review was to systematically analyse and summarise the efficacy of different interventions used in the palliation of dysphagia in primary oesophageal and gastro-oesophageal carcinoma. SEARCH METHODS To find new studies for this updated review, in January 2014 we searched, according to the Cochrane Upper Gastrointestinal and Pancreatic Diseases model, the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library), MEDLINE, EMBASE and CINAHL; and major conference proceedings (up to January 2014). SELECTION CRITERIA Only randomised controlled trials (RCTs) were included in which patients with inoperable or unresectable primary oesophageal cancer underwent palliative treatment. Different interventions like rigid plastic intubation, self-expanding metallic stent (SEMS) insertion, brachytherapy, external beam radiotherapy, chemotherapy, oesophageal bypass surgery, chemical and thermal ablation therapy, either head-to-head or in combination, were included. The primary outcome was dysphagia improvement. Secondary outcomes included recurrent dysphagia, technical success, procedure related mortality, 30-day mortality, adverse effects and quality of life. DATA COLLECTION AND ANALYSIS Data collection and analysis were performed in accordance with the methods of the Cochrane Upper Gastrointestinal and Pancreatic Diseases Review Group. MAIN RESULTS We included 3684 patients from 53 studies. SEMS insertion was safer and more effective than plastic tube insertion. Thermal and chemical ablative therapy provided comparable dysphagia palliation but had an increased requirement for re-interventions and for adverse effects. Anti-reflux stents provided comparable dysphagia palliation to conventional metal stents. Some anti-reflux stents might have reduced gastro-oesophageal reflux and complications. Newly-designed double-layered nitinol (Niti-S) stents were preferable due to longer survival time and fewer complications compared to simple Niti-S stents. Brachytherapy might be a suitable alternative to SEMS in providing a survival advantage and possibly a better quality of life, and might provide better results when combined with argon plasma coagulation or external beam radiation therapy. AUTHORS' CONCLUSIONS Self-expanding metal stent insertion is safe, effective and quicker in palliating dysphagia compared to other modalities. However, high-dose intraluminal brachytherapy is a suitable alternative and might provide additional survival benefit with a better quality of life. Some anti-reflux stents and newly-designed stents lead to longer survival and fewer complications compared to conventional stents. Combinations of brachytherapy with self-expanding metal stent insertion or radiotherapy are preferable due to the reduced requirement for re-interventions. Rigid plastic tube insertion, dilatation alone or in combination with other modalities, and chemotherapy alone are not recommended for palliation of dysphagia due to a high incidence of delayed complications and recurrent dysphagia.
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Affiliation(s)
- Yingxue Dai
- Department of Child, Adolescent and Maternal Health, Hua Xi School of Public Health, Sichuan University, 17 Ren min nan lu san duan, Chengdu, Sichuan, China, 610041
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Choi WJ, Park JJ, Park J, Lim EH, Joo MK, Yun JW, Noh H, Kim SH, Choi WS, Lee BJ, Kim JH, Yeon JE, Kim JS, Byun KS, Bak YT. Effects of the temporary placement of a self-expandable metallic stent in benign pyloric stenosis. Gut Liver 2013; 7:417-22. [PMID: 23898381 PMCID: PMC3724029 DOI: 10.5009/gnl.2013.7.4.417] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Revised: 10/24/2012] [Accepted: 10/29/2012] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND/AIMS The use of self-expandable metallic stents (SEMS) is an established palliative treatment for malignant stenosis in the gastrointestinal tract; therefore, its application to benign stenosis is expected to be beneficial because of the more gradual and sustained dilatation in the stenotic portion. We aimed in this prospective observational study to evaluate the efficacy and safety of temporary SEMS placement in benign pyloric stenosis. METHODS Twenty-two patients with benign stenosis of the prepylorus, pylorus, and duodenal bulb were enrolled and underwent SEMS placement. We assessed symptom improvement, defined as an increase of at least 1 degree in the gastric-outlet-obstruction scoring system after stent insertion. RESULTS No major complications were observed during the procedures. After stent placement, early symptom improvement was achieved in 18 of 22 patients (81.8%). During the follow-up period (mean 10.2 months), the stents remained in place successfully for 6 to 8 weeks in seven patients (31.8%). Among the 15 patients (62.5%) with stent migration, seven (46.6%) showed continued symptomatic improvement without recurrence of obstructive symptoms. CONCLUSIONS Despite the symptomatic improvement, temporary SEMS placement is premature as an effective therapeutic tool for benign pyloric stenosis unless a novel stent is developed to prevent migration.
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Affiliation(s)
- Won Jae Choi
- Division of Gastroenterology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
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Abstract
AIM: To find out whether a newly designed big cup nitinol stent is suitable for treatment of patients with gastric outlet obstruction resulting from gastric cancer.
METHODS: The new stent is composed of a proximal big cup segment (20 mm in length and 48-55 mm in diameter), a middle part (60 mm in length and 20 mm in diameter) covered by a polyethylene membrane and a distal sphericity (20 mm in length and 28 mm in diameter). Half of the proximal big cup segment is also covered by a polyethlene membrane, which is adjacent to the middle part of the stent. The stent is preloaded in a 6.0-mm-diameter introducer system. Thirteen patients with gastric outlet obstruction resulting from gastric cancer received the new stents under endoscopic and fluoroscopic guidance.
RESULTS: Technical success was achieved in 12 of 13 (92.3%) patients. Among the 12 patients in whom endoscopic stent was placed successfully, the clinical success rate was 91.7% during a follow-up of average 6.5 mo. During the first month follow-up, the migration rate was 0%, recurrent obstruction 0% and gastric bleeding 8.3%. During the follow-up between 2-12 mo, no migration, recurrent obstruction and gastric bleeding occurred.
CONCLUSION: The proximal big cup segment seems to be effective and promising for technical efficacy, clinical outcome, and preventing migration and tumor ingrowth and increasing the emptying rate of sinus ventriculi.
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[Solving of complications arising during and after application self-expandible metallic stents in palliation of malignant dysphagia]. ACTA CHIRURGICA IUGOSLAVICA 2009; 56:91-7. [PMID: 20420003 DOI: 10.2298/aci0904091s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
INTRODUCTION During palliative treatment of malignant disphagia in inoperabile patients various and serious complications may occur and compromite the method of treatment if there were not solved. AIM Goal is to present the most frequent complications due to esophageal stenting and the way of their solving. MATERIALS AND METHOD From 1996. to 2009. in 237 patients (164 esophageal carcinoma, 33 carcinoma of the esophagogastric junction, 14 bronchial carcinoma, 7 esophagojejunal anastomosis, 9 esophageal fistulas) 245 stents have been placed (54 uncovered and 191 covered). Mean survival period was 14.7 months (ranged from 1 do 33 months). Esophageal perforation (1), stent migration (9), malignant tissue ingrowth (31) and overgrowth (24) have been revealed by barium contrast study during follow up. Perforation was solved by placing covered stent, migration by removing migrated stent endoscopically or surgically, ingrowth and overgrowth by balon dilating or restenting under the fluoroscopically guidance and control. CONCLUSION One can expect and recognize complications regarding esophageal stenting because it is the only way for their sucsessfull treatment.
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Palliative endoscopic therapy for cancer patients with esophageal fistula. Chin J Cancer Res 2008. [DOI: 10.1007/s11670-008-0053-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Sundelöf M, Ringby D, Stockeld D, Granström L, Jonas E, Freedman J. Palliative treatment of malignant dysphagia with self-expanding metal stents: a 12-year experience. Scand J Gastroenterol 2007; 42:11-6. [PMID: 17190756 DOI: 10.1080/00365520600789933] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE The incidence of oesophageal cancer is increasing but the prognosis is still very poor. Around 50% of patients have advanced disease when diagnosed. Stenting using expandable metal stents is primarily aimed at palliation. The purpose of this study was to evaluate factors influencing morbidity, procedure-related mortality and symptom relief for dysphagia in patients with unresectable oesophageal cancer treated with self-expanding metal stents. MATERIAL AND METHODS We conducted a retrospective observational clinical study of consecutive patients treated with self-expanding metal stents in the Department of Surgery, Danderyd Hospital, Sweden, between January 1993 and May 2005. RESULTS One hundred and seventy-four stents were placed in 149 patients. The procedure-related mortality was 3% and the complication rate 26%. Pre- and post-treatment dysphagia could be evaluated in 139 stent placements, and showed significant improvement of dysphagia symptoms in 70% of subjects (p<0.0001). Tumour length, tumour location, histology, age, gender or prior dilatation did not affect the outcome regarding procedure-related morbidity or symptom relief. CONCLUSIONS Palliation of malignant dysphagia with self-expanding metal stents is safe and confers almost immediate improvement of dysphagia in the majority of patients. Tumour-related and demographic factors do not seem to influence the outcome.
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Affiliation(s)
- Martin Sundelöf
- Division of Surgery, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden.
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Abstract
The current concepts on diagnosis, clinical features, and management of common gastrointestinal conditions in the elderly population, taking into account physiological aspects of ageing, are evaluated. Gastrointestinal (GI) disorders are discussed with an emphasis on oesophageal problems, Helicobacter pylori infection, malabsorption, diverticular disease, and cancer. GI problems are acquiring greater importance in hospitals and in the community and their incidence is increasing. Newer treatments have less impact on patients' wellbeing and meticulously planned investigation and treatment is needed. Careful selection of patients and application of modern techniques has improved survival and outcomes, with comparable results to those in younger age groups.
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Affiliation(s)
- A L D'Souza
- Care of the Elderly, Imperial College Faculty of Medicine, Hammersmith Hospital, Du Cane Road, London W12 0NN, UK.
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Sabharwal T, Irani FG, Adam A. Quality Assurance Guidelines for Placement of Gastroduodenal Stents. Cardiovasc Intervent Radiol 2006; 30:1-5. [PMID: 17103108 DOI: 10.1007/s00270-006-0110-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- T Sabharwal
- Guy's and St. Thomas' Foundation Hospital NHS Trust, London, UK.
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Cozzi G, Chiaraviglio F, Civelli EM, Fornari S, Milella M, Salvetti M, Severini A. Self-Expanding Metal Stents in Gastrointestinal Interventional Radiology: Technical Problems. TUMORI JOURNAL 2006; 92:334-9. [PMID: 17036526 DOI: 10.1177/030089160609200413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims and background To analyze the procedural difficulties in the placement of metal stents in stenoses of the digestive tract and optimize the technique. Methods Twenty-nine patients with digestive tract stenoses were treated from January 1999 to December 2004. In 14 cases the stricture was anastomotic (9 colorectal, 3 esophageal, 1 gastroesophageal and 1 gastrojejunal), in 13 esophageal, in 1 gastric and in 1 duodenal. The stenosis was due to scarring in 5 patients and was malignant in 24 patients (primary in 17 cases and secondary in 7 cases). Results The procedure achieved technical success in all cases but 2. For each of the different segments the technical difficulties and the adopted procedural solutions were analyzed. Conclusions The interventional radiology approach yielded results comparable to those reported for the endoscopic method and was always well tolerated. The need to rely on materials mostly designed for endoscopic use can make radiological use difficult in some cases.
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Affiliation(s)
- Guido Cozzi
- Imaging Department, Istituto Nazionale Tumori, Milan.
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He X, Shin JH, Kim HC, Woo CW, Woo SH, Choi WC, Kim JG, Lim JO, Kim TH, Yoon CJ, Kang W, Song HY. Balloon sheaths for gastrointestinal guidance and access: a preliminary phantom study. Korean J Radiol 2006; 6:167-72. [PMID: 16145292 PMCID: PMC2685040 DOI: 10.3348/kjr.2005.6.3.167] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objective We wanted to evaluate the feasibility and usefulness of a newly designed balloon sheath for gastrointestinal guidance and access by conducting a phantom study. Materials and Methods The newly designed balloon sheath consisted of an introducer sheath and a supporting balloon. A coil catheter was advanced over a guide wire into two gastroduodenal phantoms (one was with stricture and one was without stricture); group I was without a balloon sheath, group ll was with a deflated balloon sheath, and groups III and IV were with an inflated balloon and with the balloon in the fundus and body, respectively. Each test was performed for 2 minutes and it was repeated 10 times in each group by two researchers, and the positions reached by the catheter tip were recorded. Results Both researchers had better performances with both phantoms in order of group IV, III, II and I. In group IV, both researchers advanced the catheter tip through the fourth duodenal segment in both the phantoms. In group I, however, the catheter tip never reached the third duodenal segment in both the phantoms by both the researchers. The numeric values for the four study groups were significantly different for both the phantoms (p < 0.001). A significant difference was also found between group III and IV for both phantoms (p < 0.001). Conclusion The balloon sheath seems to be feasible for clinical use, and it has good clinical potential for gastrointestinal guidance and access, particularly when the inflated balloon is placed in the gastric body.
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Affiliation(s)
- Xu He
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Korea
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Korea
| | - Ji Hoon Shin
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Korea
| | - Hyo-Cheol Kim
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Korea
| | - Cheol Woong Woo
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Korea
| | - Sung Ha Woo
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Korea
| | - Won-Chan Choi
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Korea
| | - Jong-Gyu Kim
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Korea
| | - Jin-Oh Lim
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Korea
| | - Tae-Hyung Kim
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Korea
| | - Chang Jin Yoon
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Korea
| | - Weechang Kang
- Department of Information and Statistics, Daejeon University, Korea
| | - Ho-Young Song
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Korea
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Scardapane A, Brindicci D, Fracella MR, Angelelli G. Post colon surgery complications: imaging findings. Eur J Radiol 2005; 53:397-409. [PMID: 15741013 DOI: 10.1016/j.ejrad.2004.12.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2004] [Revised: 12/14/2004] [Accepted: 12/17/2004] [Indexed: 01/29/2023]
Abstract
Several standardized types of colonic resections are available in the clinical practice. All of them may produce early and late complications. Diagnostic imaging plays a pivotal role in the recognition of post-operative colorectal complications and provides fundamental information for therapeutic planning. In this paper we review the imaging findings of early and late post-operative complications of colorectal surgery.
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Affiliation(s)
- Arnaldo Scardapane
- Department of Radiology, University Hospital Policlinico of Bari, Piazza Giulio Cesare, 11 - 70124 Bari, Italy.
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Ouellette J, Patterson L, Termuhlen P. Interventional options for malignant upper gastrointestinal obstruction. J Palliat Med 2005; 8:448-9. [PMID: 15890056 DOI: 10.1089/jpm.2005.8.448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Rao A, Land R, Carter J. Management of upper gastrointestinal obstruction in advanced ovarian cancer with intraluminal stents. Gynecol Oncol 2004; 95:739-41. [PMID: 15581995 DOI: 10.1016/j.ygyno.2004.08.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2004] [Indexed: 11/17/2022]
Abstract
BACKGROUND The course of many patients with end-stage gynecologic malignancy will be complicated by malignant bowel obstruction. Intraluminal stents are a novel alternative to standard surgical intervention which can involve considerable patient risk. CASES Two cases are presented of patients with upper gastrointestinal obstruction due to recurrent ovarian cancer. In the first case, a stent was utilised to provide relief from nocturnal vomiting secondary to duodenal obstruction. In the second case, stent insertion for subtotal gastric outlet obstruction provided initial relief from vomiting. However, recurrence of symptoms occurred due to stent occlusion from tumour ingrowth. CONCLUSIONS In patients with upper gastrointestinal obstruction due to recurrent gynecologic malignancy, intraluminal stents can provide useful palliation.
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Affiliation(s)
- Archana Rao
- Department of Obstetrics and Gynaecology, Royal Prince Alfred Hospital, Missenden Road, Camperdown, New South Wales 2050, Australia
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Cheng YS, Li MH, Chen WX, Chen NW, Zhuang QX, Shang KZ. Comparison of different intervention procedures in benign stricture of gastrointestinal tract. World J Gastroenterol 2004; 10:410-414. [PMID: 14760768 PMCID: PMC4723391 DOI: 10.3748/wjg.v10.i3.410] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2003] [Revised: 05/25/2003] [Accepted: 06/02/2003] [Indexed: 12/15/2022] Open
Abstract
AIM To determine the most effective intervention procedure by evaluation of mid and long-term therapeutic efficacy in patients of stricture of the gastrointestinal tract (GIT). METHODS Different intervention procedures were used to treat benign stricture of GIT in 180 patients including pneumatic dilation (group A, n=80), permanent (group B, n=25) and temporary (group C, n=75) placement of expandable metallic stents. RESULTS The diameters of the strictured GIT were significantly greater after the treatment of all procedures employed (P<0.01). For the 80 patients in group A, 160 dilations were performed (mean, 2.0 times per patient). Complications in group A included chest pain (n=20), reflux (n=16), and bleeding (n=6). Dysphagia relapse occurred in 24 (30%) and 48 (60%) patients respectively during 6-and-12 month follow-up periods in group A. In group B, 25 uncovered or partially covered or antireflux covered expandable metallic stents were placed permanently, complications included chest pain (n=10), reflux (n=15), bleeding (n=3), and stent migration (n=4), and dysphagia relapse occurred in 5 (20%) and 3 patients (25%) during the 6-and-12 month follow-up periods, respectively. In group C, the partially covered expandable metallic stents were temporarily placed in 75 patients and removed after 3 to 7 days via gastroscope, complications including chest pain (n=30), reflux (n=9), and bleeding (n=12), and dysphagia relapse occurred in 9 (12%) and 8 patients (16%) during the 6-and-12 month follow-up periods, respectively. The placement and withdrawal of stents were all successfully performed. The follow-up of all patients lasted for 6 to 96 months (mean 45.3+/-18.6 months). CONCLUSION The effective procedures for benign GIT stricture are pneumatic dilation and temporary placement of partially-covered expandable metallic stents. Temporary placement of partially-covered expandable metallic stents is one of the best methods for benign GIT strictures in mid and long-term therapeutic efficacy.
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Affiliation(s)
- Ying-Sheng Cheng
- Department of Radiology, Sixth People's Hospital, Shanghai Jiaotong University, Shanghai 200233, China.
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N/A, 官 泳. N/A. Shijie Huaren Xiaohua Zazhi 2004; 12:199-201. [DOI: 10.11569/wcjd.v12.i1.199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2023] Open
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Cheng YS, Li MH, Chen WX, Zhuang QX, Chen NW, Shang KZ. Follow-up evaluation for benign stricture of upper gastrointestinal tract with stent insertion. World J Gastroenterol 2003; 9:2609-2611. [PMID: 14606108 PMCID: PMC4656552 DOI: 10.3748/wjg.v9.i11.2609] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2003] [Revised: 05/23/2003] [Accepted: 06/02/2003] [Indexed: 02/06/2023] Open
Abstract
AIM To determine the best method for benign stricture of the upper gastrointestinal tract (UGIT) with stent insertion by follow-up evaluation. METHODS A total of 110 stents insertions were performed in 110 cases of benign stricture of the UGIT. Permanent (group A) and temporary (group B) placement of an expandable metal stent in 30 cases and 80 cases respectively. All cases were completed under fluoroscopy. RESULTS In group A, 30 uncovered or antireflux covered or partially covered expandable metal stents were placed permanently. In group A, 5 cases (16.7%) in 3-months, 5 cases (20.0%) in 6-months, 6 cases (25%) in the 1st year, 6 cases (50%) in the 3rd year, and 4 cases (80%) in the 5th year exhibited dysphagia relapse. In group B, a partially-covered expandable metal stent was temporarily placed in each patient and removed after 3-7 days via gastroscopy. Follow-up data in this group showed that 8 cases (7.5%) in 3-months, 9 cases (12.0%) in 6-months, 10 cases (15.4%) in the 1st year, 6 cases (20%) in the 3rd year, and 3 cases (25%) in the 5th year exhibited dysphagia relapse. The placement and withdrawal of all stents were all performed successfully. The follow-up of all cases lasted for 3-99 months (mean 41.6+/-19.7 months). CONCLUSION The best method for benign stricture of UGIT with stent insertion is temporary placement of a partially-covered expandable metal stent.
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Affiliation(s)
- Ying-Sheng Cheng
- Department of Radiology, Sixth People's Hospital, Shanghai Jiaotong University, Shanghai 200233, China.
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Zhang PB, Zhao XY, Li YH, Da SP. Self-expandable metal stents for dysphagia in 26 patients with advanced esophageal cancer. Shijie Huaren Xiaohua Zazhi 2003; 11:1528-1530. [DOI: 10.11569/wcjd.v11.i10.1528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM To evaluate the therapeutic effect of self-expandable metal stents for dysphagia in 26 patients with advanced esophageal cancer.
METHODS Twenty-six patients with inoperable esophageal cancer had dysphagia and were treated with self-expandable stents. After esophageal dilation, a covered self-expandable metal stent was inserted and released on the site of stenosis.
RESULTS The stent was placed successfully in all of the 26 patients. Immediate relief of dysphagia was observed, the dysphagia score decreased from 3.08 to 1.38 (P<0.01).The main complications of this procedure were chest pain, gastroesophageal reflux and obstruction of the stent.
CONCLUSION Self-expandable mental stent is a safe and effective method to palliate the dysphagia in inoperable esophageal cancer.
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Affiliation(s)
- Peng-Bin Zhang
- Department of Gastroenterology, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China
| | - Xiao-Yan Zhao
- Department of Gastroenterology, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China
| | - Yi-Hui Li
- Department of Gastroenterology, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China
| | - Si-Ping Da
- Department of Gastroenterology, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China
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