PMID- 27475489
OWN - NLM
STAT- MEDLINE
DCOM- 20170918
LR  - 20220317
IS  - 1097-6779 (Electronic)
IS  - 0016-5107 (Linking)
VI  - 85
IP  - 2
DP  - 2017 Feb
TI  - Predictors of outcomes in patients undergoing covered and uncovered 
      self-expandable metal stent placement for malignant gastric outlet obstruction: a 
      multicenter study.
PG  - 340-348.e1
LID - S0016-5107(16)30433-3 [pii]
LID - 10.1016/j.gie.2016.07.048 [doi]
AB  - BACKGROUND AND AIMS: Uncovered self-expandable metal stents (U-SEMSs) and covered 
      self-expandable metal stents (C-SEMSs) are available for palliative therapy for 
      malignant gastric outlet obstruction (GOO). However, clinical differences and 
      indications between the 2 types of SEMSs have not been elucidated. METHODS: We 
      retrospectively compared 126 patients with U-SEMS and 126 patients with C-SEMSs 
      with regard to clinical outcome and factors predictive of clinical improvement 
      after SEMSs placement. RESULTS: No significant difference was observed between 
      the U-SEMS and C-SEMS groups with respect to technical success, clinical success, 
      GOO score, or time to stent dysfunction. Stent migration was significantly more 
      frequent in patients with C-SEMSs (U-SEMSs, .79%; C-SEMSs, 8.73%; P = .005). 
      Karnofsky performance status, chemotherapy, peritoneal dissemination, and stent 
      expansion </= 30% were associated significantly with poor GOO score improvement in 
      multivariable analyses, but stent type was not (P = .213). In subgroup analyses, 
      insufficient (</=30%) stent expansion was an independent factor in patients with 
      U-SEMSs (P = .041) but not C-SEMSs. In the insufficient stent expansion subgroup, 
      C-SEMSs was associated significantly with superior clinical improvement compared 
      with U-SEMSs (P = .01). Insufficient stent expansion was observed more frequently 
      in patients with GI obstruction because of anastomotic sites or metastatic cancer 
      (44.8% [13/29], P = .001). CONCLUSIONS: No clinical difference, apart from stent 
      migration, was observed between patients with U-SEMSs and C-SEMSs. GI obstruction 
      because of an anastomotic site or metastatic cancer may be an indication for 
      C-SEMS use to improve oral intake after SEMSs placement.
CI  - Copyright (c) 2017 American Society for Gastrointestinal Endoscopy. Published by 
      Elsevier Inc. All rights reserved.
FAU - Hori, Yasuki
AU  - Hori Y
AD  - Department of Gastroenterology and Metabolism, Nagoya City University Graduate 
      School of Medical Sciences, Nagoya, Japan.
FAU - Naitoh, Itaru
AU  - Naitoh I
AD  - Department of Gastroenterology and Metabolism, Nagoya City University Graduate 
      School of Medical Sciences, Nagoya, Japan.
FAU - Hayashi, Kazuki
AU  - Hayashi K
AD  - Department of Gastroenterology and Metabolism, Nagoya City University Graduate 
      School of Medical Sciences, Nagoya, Japan.
FAU - Ban, Tesshin
AU  - Ban T
AD  - Department of Gastroenterology and Metabolism, Nagoya City University Graduate 
      School of Medical Sciences, Nagoya, Japan.
FAU - Natsume, Makoto
AU  - Natsume M
AD  - Department of Gastroenterology and Metabolism, Nagoya City University Graduate 
      School of Medical Sciences, Nagoya, Japan; Department of Gastroenterology, Midori 
      Municipal Hospital, Nagoya, Japan.
FAU - Okumura, Fumihiro
AU  - Okumura F
AD  - Department of Gastroenterology, Gifu Prefectural Tajimi Hospital, Tajimi, Japan.
FAU - Nakazawa, Takahiro
AU  - Nakazawa T
AD  - Department of Gastroenterology, Nagoya Daini Red Cross Hospital, Nagoya, Japan.
FAU - Takada, Hiroki
AU  - Takada H
AD  - Department of Gastroenterology, Kasugai Municipal Hospital, Kasugai, Japan.
FAU - Hirano, Atsuyuki
AU  - Hirano A
AD  - Department of Gastroenterology, Nagoya City West Medical Center, Nagoya, Japan.
FAU - Jinno, Naruomi
AU  - Jinno N
AD  - Department of Gastroenterology, Toyokawa City Hospital, Toyokawa, Japan.
FAU - Togawa, Shozo
AU  - Togawa S
AD  - Department of Gastroenterology, Japan Community Healthcare Organization Chukyo 
      Hospital, Nagoya, Japan.
FAU - Ando, Tomoaki
AU  - Ando T
AD  - Department of Gastroenterology, Gamagori City Hospital, Gamagori, Japan.
FAU - Kataoka, Hiromi
AU  - Kataoka H
AD  - Department of Gastroenterology and Metabolism, Nagoya City University Graduate 
      School of Medical Sciences, Nagoya, Japan.
FAU - Joh, Takashi
AU  - Joh T
AD  - Department of Gastroenterology and Metabolism, Nagoya City University Graduate 
      School of Medical Sciences, Nagoya, Japan.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
DEP - 20160727
PL  - United States
TA  - Gastrointest Endosc
JT  - Gastrointestinal endoscopy
JID - 0010505
RN  - 0 (Antineoplastic Agents)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Antineoplastic Agents/*therapeutic use
MH  - Biliary Tract Neoplasms/complications/*drug therapy
MH  - Female
MH  - Gastric Outlet Obstruction/etiology/*surgery
MH  - Gastroscopy
MH  - Humans
MH  - Karnofsky Performance Status
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Pancreatic Neoplasms/complications/*drug therapy
MH  - Peritoneal Neoplasms/secondary
MH  - Postoperative Complications/epidemiology
MH  - Retrospective Studies
MH  - Risk Factors
MH  - *Self Expandable Metallic Stents
MH  - Stomach Neoplasms/complications/*drug therapy
MH  - Treatment Outcome
EDAT- 2016/08/01 06:00
MHDA- 2017/09/19 06:00
CRDT- 2016/08/01 06:00
PHST- 2016/04/16 00:00 [received]
PHST- 2016/07/01 00:00 [accepted]
PHST- 2016/08/01 06:00 [pubmed]
PHST- 2017/09/19 06:00 [medline]
PHST- 2016/08/01 06:00 [entrez]
AID - S0016-5107(16)30433-3 [pii]
AID - 10.1016/j.gie.2016.07.048 [doi]
PST - ppublish
SO  - Gastrointest Endosc. 2017 Feb;85(2):340-348.e1. doi: 10.1016/j.gie.2016.07.048. 
      Epub 2016 Jul 27.