PMID- 34611264
OWN - NLM
STAT- MEDLINE
DCOM- 20211229
LR  - 20211229
IS  - 2045-2322 (Electronic)
IS  - 2045-2322 (Linking)
VI  - 11
IP  - 1
DP  - 2021 Oct 5
TI  - A pilot study of novel duodenal covered self-expandable metal stent fixation.
PG  - 19708
LID - 10.1038/s41598-021-99265-1 [doi]
LID - 19708
AB  - 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.
CI  - (c) 2021. The Author(s).
FAU - Hori, Yasuki
AU  - Hori Y
AD  - Department of Gastroenterology and Metabolism, Nagoya City University Graduate 
      School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, 
      Japan. yhori@med.nagoya-cu.ac.jp.
FAU - Hayashi, Kazuki
AU  - Hayashi K
AD  - Department of Gastroenterology and Metabolism, Nagoya City University Graduate 
      School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, 
      Japan.
FAU - Naitoh, Itaru
AU  - Naitoh I
AD  - Department of Gastroenterology and Metabolism, Nagoya City University Graduate 
      School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, 
      Japan.
FAU - Miyabe, Katsuyuki
AU  - Miyabe K
AD  - Department of Gastroenterology and Metabolism, Nagoya City University Graduate 
      School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, 
      Japan.
FAU - Natsume, Makoto
AU  - Natsume M
AD  - Department of Gastroenterology and Metabolism, Nagoya City University Graduate 
      School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, 
      Japan.
FAU - Yoshida, Michihiro
AU  - Yoshida M
AD  - Department of Gastroenterology and Metabolism, Nagoya City University Graduate 
      School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, 
      Japan.
FAU - Kataoka, Hiromi
AU  - Kataoka H
AD  - Department of Gastroenterology and Metabolism, Nagoya City University Graduate 
      School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, 
      Japan.
LA  - eng
PT  - Journal Article
DEP - 20211005
PL  - England
TA  - Sci Rep
JT  - Scientific reports
JID - 101563288
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Duodenum/*surgery
MH  - Female
MH  - Gastric Outlet Obstruction/*complications/etiology/mortality/*surgery
MH  - Gastrointestinal Neoplasms/complications/diagnosis/surgery
MH  - Humans
MH  - Male
MH  - Postoperative Complications/etiology/therapy
MH  - Prognosis
MH  - Self Expandable Metallic Stents/*adverse effects
MH  - Survival Analysis
MH  - Treatment Outcome
PMC - PMC8492690
COIS- The authors declare no competing interests.
EDAT- 2021/10/07 06:00
MHDA- 2021/12/30 06:00
PMCR- 2021/10/05
CRDT- 2021/10/06 06:37
PHST- 2021/05/19 00:00 [received]
PHST- 2021/09/22 00:00 [accepted]
PHST- 2021/10/06 06:37 [entrez]
PHST- 2021/10/07 06:00 [pubmed]
PHST- 2021/12/30 06:00 [medline]
PHST- 2021/10/05 00:00 [pmc-release]
AID - 10.1038/s41598-021-99265-1 [pii]
AID - 99265 [pii]
AID - 10.1038/s41598-021-99265-1 [doi]
PST - epublish
SO  - Sci Rep. 2021 Oct 5;11(1):19708. doi: 10.1038/s41598-021-99265-1.