Covered versus uncovered self-expandable metallic stents for palliation of malignant pyloric obstruction in gastric cancer patients: a randomized, prospective study - 24/08/11
Reprint requests: Il Ju Choi, MD, PhD, Center for Gastric Cancer, National Cancer Center, 111 Jungbalsan-ro, Ilsandong-gu, Goyang, Gyeonggi, 410-769, KoreaRésumé |
Background |
Self-expandable metallic stents (SEMSs) provide effective palliation of malignant pyloric obstruction in patients with inoperable gastric cancer.
Objective |
To compare the effectiveness and side effects of covered and uncovered SEMSs for the palliation of malignant pyloric obstruction.
Design |
Prospective, randomized, single-center study.
Setting |
Tertiary-care cancer center hospital.
Patients |
This study involved 80 patients with pyloric obstruction related to inoperable gastric cancer.
Intervention |
Covered or uncovered SEMS placement.
Main Outcome Measurements |
Technical and clinical success rates as well as the patency rate at 8 weeks after placement.
Results |
Both groups had a technical success rate of 100% with no immediate complications. Both groups also had comparable clinical success rates (covered SEMS, 95% [38 of 40] and uncovered SEMS, 90% [36 of 40], P = .68) and 8-week patency rates (covered SEMS, 61.3% [19 of 31] and uncovered SEMS, 61.1% [22 of 36], P > .99). Stent migration within 8 weeks was more common in the covered SEMS group (25.8% [8 of 31]) than in the uncovered SEMS group (2.8% [1 of 36], P = .009), whereas re-stenosis because of tumor ingrowth was more common in the uncovered SEMS group (25.0% [9 of 36] vs 0% [0 of 31] in the covered SEMS group, P = .003). Overall patient survival and stent patency did not differ between groups (P = .27 and 0.61 by log-rank test, respectively).
Limitations |
The study population was limited to gastric cancer patients, and stent designs were changed in the midst of the study period.
Conclusion |
Both the covered and uncovered SEMSs are effective and have comparable 8-week patency in patients with malignant pyloric obstruction, despite different patterns of late stent failure.
Le texte complet de cet article est disponible en PDF.Abbreviations : GOO, GOOSS, SEMS
Plan
| DISCLOSURE: All authors disclosed no financial relationships relevant to this publication. Dr Il Ju Choi was supported by grant 0910090 from the National Cancer Center, Korea. |
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| See CME section; p. 177 |
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| If you would like to chat with an author of this article, you may contact Dr Choi at cij1224@hanmail.net. |
Vol 72 - N° 1
P. 25-32 - juillet 2010 Retour au numéro
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