Abstract
Self-expandable metal stents (SEMS) have gained acceptance for use in the gastrointestinal tract in order to relieve malignant luminal obstruction. In the upper gastrointestinal tract SEMS are used as an alternative to surgical bypass for palliation of malignant gastric-outlet obstruction. In the colon, SEMS are used to avoid colostomy during palliation and as a bridge to surgery for left-sided colonic obstruction. Enteral SEMS appear to be cost effective. This article reviews the latest in stent technology as well as the outcomes following their placement.
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References
Baron TH (2001) Expandable metal stents for the treatment of cancerous obstruction of the gastrointestinal tract. N Engl J Med 31: 1681–1687
Topazian M et al. (1992) Palliation of obstructing gastric cancer with steel mesh, self-expanding endoprostheses. Gastrointest Endosc 38: 58–60
Maetani I et al. (2000) Knitted nitinol stent insertion for various intestinal stenoses with a modified delivery system. Gastrointest Endosc 54: 364–367
Maetani I et al. (2002) Technical modifications and strategies for stenting gastric outlet strictures using esophageal endoprostheses. Endoscopy 34: 402–406
Mosler P et al. (2005) Palliation of gastric outlet obstruction and proximal small bowel obstruction with self-expandable metal stents: a single center series. J Clin Gastroenterol 39: 124–128
Fiori E et al. (2004) Palliative management of malignant antro-pyloric strictures. Gastroenterostomy vs endoscopic stenting. A randomized prospective trial. Anticancer Res 24: 269–271
Johnsson E et al. (2004) Palliation of malignant gastroduodenal obstruction with open surgical bypass or endoscopic stenting: clinical outcome and health economic evaluation. World J Surg 28: 812–817
Mittal A et al. (2004) Matched study of three methods for palliation of malignant pyloroduodenal obstruction. Br J Surg 91: 205–209
Dormann A et al. (2004) Self-expanding metal stents for gastroduodenal malignancies: systematic review of their clinical effectiveness. Endoscopy 36: 543–550
Adler DG and Baron TH (2002) Endoscopic palliation of malignant gastric outlet obstruction using self-expandable metal stents: experience in 36 patients. Am J Gastro 97: 72–78
Song HY et al. (2004) A dual expandable nitinol stent: experience in 102 patients with malignant gastroduodenal strictures. J Vasc Interv Radiol 15: 1443–1449
Kim GH et al. (2004) Which types of stent, uncovered or covered, should be used in gastric outlet obstructions? Scand J Gastroenterol 39: 1010–1014
Holt AP et al. (2004) Palliation of patients with malignant gastroduodenal obstruction with self-expanding metallic stents: the treatment of choice? Gastrointest Endosc 60: 1010–1017
Telford JJ et al. (2004) Palliation of patients with malignant gastric outlet obstruction with the enteral Wallstent: outcomes from a multicenter study. Gastrointest Endosc 60: 916–920
Bethge N et al. (1996) Human tissue responses to metal stents implanted in vivo for the palliation of malignant stenoses. Gastrointest Endosc 43: 596–602
Choi YB (2002) Laparoscopic gastrojejunostomy for palliation of gastric outlet obstruction in unresectable gastric cancer. Surg Endosc 16: 1620–1626
Dohmoto M (1991) Endoscopic implantation of rectal stents in palliative treatment of malignant stenosis. Endosc Dig 3: 1507–1512
Baron TH (2003) Benign and malignant colorectal strictures. In Colonoscopy: principles and practice, 611–623 (Eds Waye JD et al.) Massachusetts: Blackwell Publishing
Tejero E et al. (1994) New procedure for the treatment of colorectal neoplastic obstructions. Dis Colon Rectum 37: 1158–1159
Horiuchi A et al. (2001) Usefulness of Dennis colorectal tube in endoscopic decompression of acute, malignant colonic obstruction. Gastrointest Endosc 54: 229–232
Tanaka T et al. (2001) Endoscopic transanal decompression with a drainage tube for acute colonic obstruction: clinical aspects of preoperative treatment. Dis Colon Rectum 44: 418–422
Saida Y et al. (2003) Long-term prognosis of preoperative “bridge to surgery” expandable metallic stent insertion for obstructive colorectal cancer: comparison with emergency operation. Dis Colon Rectum 46 (Suppl): S44–S49
Repici A et al. (2000) Self-expanding covered esophageal Ultraflex stent for palliation of malignant colorectal anastomotic obstruction complicated by multiple fistulas. Gastrointest Endosc 51: 346–348
Khot UP et al. (2002) Systematic review of the efficacy and safety of colorectal stents. Br J Surg 89: 1096–1102
Sebastian S et al. (2004) Pooled analysis of the efficacy and safety of self-expanding metal stenting in malignant colorectal obstruction. Am J Gastroenterol 99: 2051–2057
Binkert CA et al. (1998) Acute colonic obstruction: clinical aspects and cost-effectiveness of preoperative and palliative treatment with self-expanding metallic stents – a preliminary report. Radiology 206: 199–204
Xinopoulos D et al. (2004) Stenting or stoma creation for patients with inoperable malignant colonic obstructions? Results of a study and cost-effectiveness analysis. Surg Endosc 18: 421–426
Osman HS et al. (2000) The cost-effectiveness of self-expanding metal stents in the management of malignant left-sided large bowel obstruction. Colorectal Dis 2: 233–237
Targownik LE et al. (2004) Colonic stent vs emergency surgery for management of acute left-sided malignant colonic obstruction: a decision analysis. Gastrointest Endosc 60: 865–874
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Glossary
- STENT MIGRATION
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A complication of stent placement, in which the stent is displaced proximally or distally
- TUMOR INGROWTH
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A complication of stent placement in which tumor growth extends between the struts of a stent into the lumen
- TUMOR OVERGROWTH
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A complication of stent placement in which tumor growth extends beyond the length of a previously placed luminal stent
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Simmons, D., Baron, T. Technology Insight: enteral stenting and new technology. Nat Rev Gastroenterol Hepatol 2, 365–374 (2005). https://doi.org/10.1038/ncpgasthep0236
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DOI: https://doi.org/10.1038/ncpgasthep0236
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