Tsuboi A, Kuwai T, Nishimura T, Iio S, Mori T, Imagawa H, Yamaguchi T, Yamaguchi A, Kouno H, Kohno H. Safety and efficacy of self-expandable metallic stents in malignant small bowel obstructions. World J Gastroenterol 2016; 22(40): 9022-9027 [PMID: 27833393 DOI: 10.3748/wjg.v22.i40.9022]
Corresponding Author of This Article
Toshio Kuwai, MD, PhD, Department of Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, 3-1 Aoyamacho, Kure 737-0023, Japan. kuwait@kure-nh.go.jp
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Akiyoshi Tsuboi, Toshio Kuwai, Tomoyuki Nishimura, Sumio Iio, Takeshi Mori, Hiroki Imagawa, Toshiki Yamaguchi, Atsushi Yamaguchi, Hirotaka Kouno, Hiroshi Kohno, Department of Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure 737-0023, Japan
Author contributions: Tsuboi A wrote the manuscript; Kuwai T assessed the patients; Nishimura T, Iio S and Mori T assisted in performing the diagnostic tests; Imagawa H and Yamaguchi T interpreted data; Yamaguchi A, Kouno H and Kohno H critically reviewed the manuscript.
Institutional review board statement: Ethical approval was not needed for this study, given the case series nature of the manuscript.
Informed consent statement: Informed consent was obtained from each of the patients.
Conflict-of-interest statement: There are no conflicts of interest to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Toshio Kuwai, MD, PhD, Department of Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, 3-1 Aoyamacho, Kure 737-0023, Japan. kuwait@kure-nh.go.jp
Telephone: +81-823-223111 Fax: +81-823-210478
Received: May 16, 2016 Peer-review started: May 17, 2016 First decision: July 12, 2016 Revised: August 25, 2016 Accepted: September 6, 2016 Article in press: September 6, 2016 Published online: October 28, 2016 Processing time: 163 Days and 1.9 Hours
Abstract
In this report, we present 3 cases of malignant small bowel obstruction, treated with palliative care using endoscopic self-expandable metallic stent (SEMS) placement, with the aim to identify the safety and efficacy of this procedure. Baseline patient characteristics, procedure methods, procedure time, technical and clinical success rates, complications, and patient outcomes were obtained. All 3 patients had pancreatic cancer with small bowel strictures. One patient received the SEMS using colonoscopy, while the other 2 patients received SEMS placement via double balloon endoscopy using the through-the-overtube technique. The median procedure time was 104 min. The technical and clinical success rates were 100%. Post-treatment, obstructive symptoms in all patients improved, and a low-residue diet could be tolerated. All stents remained within the patients until their deaths. The median overall survival time (stent patency time) was 76 d. SEMS placement is safe and effective as a palliative treatment for malignant small bowel obstruction.
Core tip: We present 3 cases of malignant small bowel obstruction, treated with palliative care using endoscopic self-expandable metallic stent (SEMS) placement, and have identified that the procedure is safe and effective. Two patients were treated using the through-the-overtube technique, while the remaining case was the first case of SEMS placement in a malignant distal small bowel obstruction.
