A pilot study of novel duodenal covered self-expandable metal stent fixation

Abstract Migration of duodenal covered self-expandable metal stents (C-SEMSs) is the main cause of stent dysfunction in patients with malignant gastric outlet obstruction (mGOO). Because endoscopic SEMS placement is frequently selected in patients with poor performance status, we concurrently focuse...

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Autores principales: Yasuki Hori, Kazuki Hayashi, Itaru Naitoh, Katsuyuki Miyabe, Makoto Natsume, Michihiro Yoshida, Hiromi Kataoka
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Publicado: Nature Portfolio 2021
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Acceso en línea:https://doaj.org/article/b1c81d0ac2924c94bd8cc07c7fdef311
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spelling oai:doaj.org-article:b1c81d0ac2924c94bd8cc07c7fdef3112021-12-02T18:37:10ZA pilot study of novel duodenal covered self-expandable metal stent fixation10.1038/s41598-021-99265-12045-2322https://doaj.org/article/b1c81d0ac2924c94bd8cc07c7fdef3112021-10-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-99265-1https://doaj.org/toc/2045-2322Abstract Migration of duodenal covered self-expandable metal stents (C-SEMSs) is the main cause of stent dysfunction in patients with malignant gastric outlet obstruction (mGOO). Because endoscopic SEMS placement is frequently selected in patients with poor performance status, we concurrently focused on the safety of the treatment. This pilot study included 15 consecutive patients with mGOO who underwent duodenal partially covered SEMS (PC-SEMS) placement with fixation using an over-the-scope-clip (OTSC). Technical feasibility, clinical success for oral intake estimated by the Gastric Outlet Obstruction Scoring System (GOOSS) score, and adverse events including stent migration were retrospectively assessed. All procedures were successful, and clinical success was achieved in 86.7% (13/15). Mean GOOSS scores were improved from 0.07 to 2.53 after the procedure (P < 0.001). Median survival time was 84 days, and all patients were followed up until death. Stent migration occurred in one case (6.7%) at day 17, which was successfully treated by removal of the migrated PC-SEMS using an enteroscope. For fixation using an OTSC, additional time required for the procedure was 8.9 ± 4.1 min and we did not observe OTSC-associated adverse events. Poor performance status was associated with clinical success (P = 0.03), but we could provide the treatment safely and reduce mGOO symptoms even in patients with poor performance status. In conclusion, duodenal PC-SEMS fixation using an OTSC is feasible for preventing stent migration in patients with mGOO including those with poor performance status.Yasuki HoriKazuki HayashiItaru NaitohKatsuyuki MiyabeMakoto NatsumeMichihiro YoshidaHiromi KataokaNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Yasuki Hori
Kazuki Hayashi
Itaru Naitoh
Katsuyuki Miyabe
Makoto Natsume
Michihiro Yoshida
Hiromi Kataoka
A pilot study of novel duodenal covered self-expandable metal stent fixation
description Abstract Migration of duodenal covered self-expandable metal stents (C-SEMSs) is the main cause of stent dysfunction in patients with malignant gastric outlet obstruction (mGOO). Because endoscopic SEMS placement is frequently selected in patients with poor performance status, we concurrently focused on the safety of the treatment. This pilot study included 15 consecutive patients with mGOO who underwent duodenal partially covered SEMS (PC-SEMS) placement with fixation using an over-the-scope-clip (OTSC). Technical feasibility, clinical success for oral intake estimated by the Gastric Outlet Obstruction Scoring System (GOOSS) score, and adverse events including stent migration were retrospectively assessed. All procedures were successful, and clinical success was achieved in 86.7% (13/15). Mean GOOSS scores were improved from 0.07 to 2.53 after the procedure (P < 0.001). Median survival time was 84 days, and all patients were followed up until death. Stent migration occurred in one case (6.7%) at day 17, which was successfully treated by removal of the migrated PC-SEMS using an enteroscope. For fixation using an OTSC, additional time required for the procedure was 8.9 ± 4.1 min and we did not observe OTSC-associated adverse events. Poor performance status was associated with clinical success (P = 0.03), but we could provide the treatment safely and reduce mGOO symptoms even in patients with poor performance status. In conclusion, duodenal PC-SEMS fixation using an OTSC is feasible for preventing stent migration in patients with mGOO including those with poor performance status.
format article
author Yasuki Hori
Kazuki Hayashi
Itaru Naitoh
Katsuyuki Miyabe
Makoto Natsume
Michihiro Yoshida
Hiromi Kataoka
author_facet Yasuki Hori
Kazuki Hayashi
Itaru Naitoh
Katsuyuki Miyabe
Makoto Natsume
Michihiro Yoshida
Hiromi Kataoka
author_sort Yasuki Hori
title A pilot study of novel duodenal covered self-expandable metal stent fixation
title_short A pilot study of novel duodenal covered self-expandable metal stent fixation
title_full A pilot study of novel duodenal covered self-expandable metal stent fixation
title_fullStr A pilot study of novel duodenal covered self-expandable metal stent fixation
title_full_unstemmed A pilot study of novel duodenal covered self-expandable metal stent fixation
title_sort pilot study of novel duodenal covered self-expandable metal stent fixation
publisher Nature Portfolio
publishDate 2021
url https://doaj.org/article/b1c81d0ac2924c94bd8cc07c7fdef311
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