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Erschienen in: Journal of Gastrointestinal Cancer 1/2015

01.03.2015 | Original Research

Enteral Stents are Safe and Effective to Relieve Malignant Gastric Outlet Obstruction in the Elderly

verfasst von: Hala Mansoor, Faisal Zeb

Erschienen in: Journal of Gastrointestinal Cancer | Ausgabe 1/2015

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Abstract

Background

Nausea, vomiting and intolerance to oral intake are usually the first presenting symptoms of gastric outlet obstruction, which not only cause malnutrition and increases chances of aspiration pneumonia but also greatly impair the quality of life. Self expandable metallic stents (SEMS) are both effective and safe to relieve the distressing symptoms of gastric outlet obstruction. The aim of this study was to compare the outcomes of endoscopic enteral stent insertion in malignant gastric outlet obstruction in older versus younger patients.

Methods

Eighty two patients were identified to have undergone SEMs insertion for malignant gastric outlet obstruction. Of these, 26 were ≥65 years (older patient group) and 56 were ≤65 years (younger patient group). These were retrospectively reviewed to assess the success rate and the complications of the procedure.

Results

Both groups were comparable in terms of technical success (100 % in older patient group versus 97 % in younger patient group). Clinical success rate, as determined by gastric outlet obstruction scoring system score (GOOSS) was also similar in both groups. Additionally, the rate of complications in both groups was also comparable, 27 % in older patient versus 23 % in younger patients (p = 0.085).

Conclusion

Enteral stenting for malignant gastric outlet obstruction is effective in the older patient groups with its success rate and complications comparable to younger patient population.
Literatur
1.
Zurück zum Zitat Sabharwal T, Irani FG, Adam A. Quality assurance guidelines for placement of gastroduodenal stents. Cardiovasc Intervent Radiol. 2007;30:1–5.CrossRefPubMed Sabharwal T, Irani FG, Adam A. Quality assurance guidelines for placement of gastroduodenal stents. Cardiovasc Intervent Radiol. 2007;30:1–5.CrossRefPubMed
2.
Zurück zum Zitat Jung GS, Song HY, Kang SG, Huh JD, Park SJ, Koo JY, et al. Malignant gastroduodenal obstruction: treatment by means of a covered expandable metallic stent-initial experience. Radiology. 2000;216:758–63.CrossRefPubMed Jung GS, Song HY, Kang SG, Huh JD, Park SJ, Koo JY, et al. Malignant gastroduodenal obstruction: treatment by means of a covered expandable metallic stent-initial experience. Radiology. 2000;216:758–63.CrossRefPubMed
3.
Zurück zum Zitat Bessoud B, de Baere T, Denys A, Kouch V, Ducreux M, Precetti S, et al. Malignant gastroduodenal obstruction: palliation with self-expanding metallic stents. J Vasc Interv Radiol. 2005;16:247–53.CrossRefPubMed Bessoud B, de Baere T, Denys A, Kouch V, Ducreux M, Precetti S, et al. Malignant gastroduodenal obstruction: palliation with self-expanding metallic stents. J Vasc Interv Radiol. 2005;16:247–53.CrossRefPubMed
4.
Zurück zum Zitat Tada M, Nakai Y, Sasaki T, Hamada T, Nagano R, Mohvi D, et al. Recent progress and limitations of chemotherapy for pancreatic and biliary tract cancers. World J Clin Oncol. 2011;2:158–63.CrossRefPubMedCentralPubMed Tada M, Nakai Y, Sasaki T, Hamada T, Nagano R, Mohvi D, et al. Recent progress and limitations of chemotherapy for pancreatic and biliary tract cancers. World J Clin Oncol. 2011;2:158–63.CrossRefPubMedCentralPubMed
5.
Zurück zum Zitat Koizumi W, Narahara H, Hara T, Takagane A, Akiya T, Takagi M, et al. S-1 plus cisplatin versus S-1 alone for first time treatment of advanced gastric cancer (SPIRITS trial): a phase III trial. Lancet Oncol. 2008;9:215–21.CrossRefPubMed Koizumi W, Narahara H, Hara T, Takagane A, Akiya T, Takagi M, et al. S-1 plus cisplatin versus S-1 alone for first time treatment of advanced gastric cancer (SPIRITS trial): a phase III trial. Lancet Oncol. 2008;9:215–21.CrossRefPubMed
6.
Zurück zum Zitat Nakai Y, Isayama H, Sasaki T, Sasahira N, Ito Y, Kogure H, et al. Impact of S-1 on the survival of patients with advanced pancreatic cancer. Pancreas. 2010;39:989–93.CrossRefPubMed Nakai Y, Isayama H, Sasaki T, Sasahira N, Ito Y, Kogure H, et al. Impact of S-1 on the survival of patients with advanced pancreatic cancer. Pancreas. 2010;39:989–93.CrossRefPubMed
7.
Zurück zum Zitat Sasaki T, Isayama H, Nakai Y, Ito Y, Kogure H, Togawa O, et al. Multicenter, phase II study of gemcitabine and S-1 combination chemotherapy in patients with advanced biliary tract cancer. Cancer Chemother Pharmacol. 2010;65:1101–7.CrossRefPubMed Sasaki T, Isayama H, Nakai Y, Ito Y, Kogure H, Togawa O, et al. Multicenter, phase II study of gemcitabine and S-1 combination chemotherapy in patients with advanced biliary tract cancer. Cancer Chemother Pharmacol. 2010;65:1101–7.CrossRefPubMed
8.
Zurück zum Zitat Sasaki T, Isayama H, Nakai Y, Mizuno S, Yamamoto K, Yagioka H, et al. Multicenter phase II study of S-1 monotherapy as second line chemotherapy for advanced biliary tract cancer refractory to gemcitabine. Invest New Drugs. 2012;30:708–13.CrossRefPubMed Sasaki T, Isayama H, Nakai Y, Mizuno S, Yamamoto K, Yagioka H, et al. Multicenter phase II study of S-1 monotherapy as second line chemotherapy for advanced biliary tract cancer refractory to gemcitabine. Invest New Drugs. 2012;30:708–13.CrossRefPubMed
9.
Zurück zum Zitat Maetanni I, Akatsuka S, Ikeda M, Tada T, Ukita T, Nakamura Y, et al. Self expandable metallic stent placement for palliation in gastric outlet obstructions caused by gastric cancer: a comparison with surgical gastrojejunostomy. J Gastroenterol. 2005;40:932–7.CrossRef Maetanni I, Akatsuka S, Ikeda M, Tada T, Ukita T, Nakamura Y, et al. Self expandable metallic stent placement for palliation in gastric outlet obstructions caused by gastric cancer: a comparison with surgical gastrojejunostomy. J Gastroenterol. 2005;40:932–7.CrossRef
10.
Zurück zum Zitat Hosono S, Ohtani H, Arimoto Y, Kanamiya Y. Endoscopic stenting vs. surgical gastroenterostomy for palliation of malignant gastroduodenal obstruction: a meta-analysis. J Gastroenterol. 2007;42:283–90.CrossRefPubMed Hosono S, Ohtani H, Arimoto Y, Kanamiya Y. Endoscopic stenting vs. surgical gastroenterostomy for palliation of malignant gastroduodenal obstruction: a meta-analysis. J Gastroenterol. 2007;42:283–90.CrossRefPubMed
11.
Zurück zum Zitat Cunningham D, Allum WH, Stenning SP, Thompson JN, Van de Velde CJ, Nicolson M, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med. 2006;355:11–20.CrossRefPubMed Cunningham D, Allum WH, Stenning SP, Thompson JN, Van de Velde CJ, Nicolson M, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med. 2006;355:11–20.CrossRefPubMed
12.
Zurück zum Zitat Piesman M, Kozarek RA, Brandabur JJ, Pleskow DK, Chuttani R, Eysselein VE. Improved oral intake after palliative duodenal stenting for malignant obstruction. A prospective multicenter clinical trial. Am J Gastroenterol. 2009;104:2404–11.CrossRefPubMed Piesman M, Kozarek RA, Brandabur JJ, Pleskow DK, Chuttani R, Eysselein VE. Improved oral intake after palliative duodenal stenting for malignant obstruction. A prospective multicenter clinical trial. Am J Gastroenterol. 2009;104:2404–11.CrossRefPubMed
13.
Zurück zum Zitat van Hooft J, Mutignani M, Repici A, Messmann H, Neuhaus H. First data on the palliative treatment of patients with malignant gastric outlet obstruction using the WallFlex enteral stent: a retrospective multicenter study. Endoscopy. 2007;39:434–9.CrossRefPubMed van Hooft J, Mutignani M, Repici A, Messmann H, Neuhaus H. First data on the palliative treatment of patients with malignant gastric outlet obstruction using the WallFlex enteral stent: a retrospective multicenter study. Endoscopy. 2007;39:434–9.CrossRefPubMed
15.
Zurück zum Zitat Hanada K, Hino F, Amano H, Fukuda T, Kuroda Y. Current treatment strategies for pancreatic cancer in the elderly. Drugs Aging. 2006;23:403–10.CrossRefPubMed Hanada K, Hino F, Amano H, Fukuda T, Kuroda Y. Current treatment strategies for pancreatic cancer in the elderly. Drugs Aging. 2006;23:403–10.CrossRefPubMed
16.
Zurück zum Zitat Watanapa P, Williamson RC. Surgical palliation for pancreatic cancer: developments during the past two decades. Br J Surg. 1992;79:8–20.CrossRefPubMed Watanapa P, Williamson RC. Surgical palliation for pancreatic cancer: developments during the past two decades. Br J Surg. 1992;79:8–20.CrossRefPubMed
17.
Zurück zum Zitat Dormann AJ. Endoscopic palliation and nutritional support in advanced gastric cancer. Dig Dis. 2004;22:351–9.CrossRefPubMed Dormann AJ. Endoscopic palliation and nutritional support in advanced gastric cancer. Dig Dis. 2004;22:351–9.CrossRefPubMed
18.
Zurück zum Zitat Tierney W, Chuttani R, Croffie J, DiSairo J, Liu J, Mishkin DS, et al. Enteral stent. Gastrointest Endosc. 2006;63:920–6.CrossRefPubMed Tierney W, Chuttani R, Croffie J, DiSairo J, Liu J, Mishkin DS, et al. Enteral stent. Gastrointest Endosc. 2006;63:920–6.CrossRefPubMed
19.
Zurück zum Zitat Fiori E, Lamazza A, Volpino P, Burza A, Paparelli C, Cavallaro G. Palliative management of malignant antro-pyloric strictures: gastroenterostomy vs. endoscopic stenting. A randomized prospective trial. Anticancer Res. 2004;24:269–71.PubMed Fiori E, Lamazza A, Volpino P, Burza A, Paparelli C, Cavallaro G. Palliative management of malignant antro-pyloric strictures: gastroenterostomy vs. endoscopic stenting. A randomized prospective trial. Anticancer Res. 2004;24:269–71.PubMed
20.
Zurück zum Zitat Mehta S, Hindmarsh A, Cheong E, Cockburn J, Saada J, Tighe R. Prospective randomized trial of laparoscopic gastrojejunostomy versus duodenal stenting for malignant gastric outflow obstruction. Surg Endosc. 2006;20:239–42.CrossRefPubMed Mehta S, Hindmarsh A, Cheong E, Cockburn J, Saada J, Tighe R. Prospective randomized trial of laparoscopic gastrojejunostomy versus duodenal stenting for malignant gastric outflow obstruction. Surg Endosc. 2006;20:239–42.CrossRefPubMed
21.
Zurück zum Zitat Froehlich F, Gonvers JJ, Vader JP, Dubois RW, Burnand B. Appropriateness of gastrointestinal endoscopy: risk of complications. Endoscopy. 1999;31:684–6.CrossRefPubMed Froehlich F, Gonvers JJ, Vader JP, Dubois RW, Burnand B. Appropriateness of gastrointestinal endoscopy: risk of complications. Endoscopy. 1999;31:684–6.CrossRefPubMed
22.
Zurück zum Zitat Mansoor H, Yusuf MA. Outcomes of endoscopic pyloric stenting in malignant gastric outlet obstruction: a retrospective study. BMC Res Notes. 2013;6:280.CrossRefPubMedCentralPubMed Mansoor H, Yusuf MA. Outcomes of endoscopic pyloric stenting in malignant gastric outlet obstruction: a retrospective study. BMC Res Notes. 2013;6:280.CrossRefPubMedCentralPubMed
23.
Zurück zum Zitat Yk C, Kim SW, Hur WH, Nam KW, Chang JH, Park JM, et al. Clinical outcomes of self-expandable metal stent and prognostic factors for stent patency in gastric obstruction caused by gastric cancer. Dig Dis Sci. 2010;55:668–74.CrossRef Yk C, Kim SW, Hur WH, Nam KW, Chang JH, Park JM, et al. Clinical outcomes of self-expandable metal stent and prognostic factors for stent patency in gastric obstruction caused by gastric cancer. Dig Dis Sci. 2010;55:668–74.CrossRef
24.
Zurück zum Zitat van Hooft JE, Uitdehaag MJ, Bruno M, Timmer R, Siersema PD, Dijkgraf MG, et al. Efficacy and safety of the new WallFlex enteral stent in palliative treatment of malignant gastric outlet obstruction (DUOFLEX study):a prospective multicenter study. Gastrointest Endosc. 2009;69:1059–66.CrossRefPubMed van Hooft JE, Uitdehaag MJ, Bruno M, Timmer R, Siersema PD, Dijkgraf MG, et al. Efficacy and safety of the new WallFlex enteral stent in palliative treatment of malignant gastric outlet obstruction (DUOFLEX study):a prospective multicenter study. Gastrointest Endosc. 2009;69:1059–66.CrossRefPubMed
25.
Zurück zum Zitat Cha BH, Lee SH, Kim JE, Yoo JY, Park YS, Kim JW, et al. Endoscopic self-expandable metallic stent placement in malignant pyloric or duodenal obstruction: does chemotherapy affect stent patency? Asia Pac J Clin Oncol. 2013;9:162–8.CrossRefPubMed Cha BH, Lee SH, Kim JE, Yoo JY, Park YS, Kim JW, et al. Endoscopic self-expandable metallic stent placement in malignant pyloric or duodenal obstruction: does chemotherapy affect stent patency? Asia Pac J Clin Oncol. 2013;9:162–8.CrossRefPubMed
Metadaten
Titel
Enteral Stents are Safe and Effective to Relieve Malignant Gastric Outlet Obstruction in the Elderly
verfasst von
Hala Mansoor
Faisal Zeb
Publikationsdatum
01.03.2015
Verlag
Springer US
Erschienen in
Journal of Gastrointestinal Cancer / Ausgabe 1/2015
Print ISSN: 1941-6628
Elektronische ISSN: 1941-6636
DOI
https://doi.org/10.1007/s12029-014-9675-y

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