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CardioVascular and Interventional Radiology

, Volume 24, Issue 1, pp 25–30 | Cite as

Palliation of postoperative gastrointestinal anastomotic malignant strictures with flexible covered metallic stents: Preliminary results

  • Jeong-Min LeeEmail author
  • Young Min Han
  • Sang Yong Lee
  • Chong Soo Kim
  • Doo Hyun Yang
  • Seung Ok Lee
Clinical Investigations

Abstract

Purpose: To evaluate the efficacy of the placement of covered metallic stents for palliation of gastrointestinal anastomotic strictures secondary to recurrent gastric cancer.

Methods: Under fluoroscopic guidance, placement of one or two self-expandable covered metallic stents was attempted perorally in 11 patents (aged 48-76 years) with anastomotic stenoses due to recurrent gastric malignancies. The strictures involved both the afferent and efferent loops in three patients. All patients had poor peroral food intake with severe nausea and vomiting after ingestion. The technical and clinical success was evaluated.

Results: Placement of the covered stent was technically successful in 13 of 15 (87%) attempts in ten patients. After the procedure, 9 of 11 (82%) patients overall were able to ingest at least a liquid diet and had markedly decreased incidence of vomiting. During the follow-up of 2–31 weeks (mean 8.5 weeks) there were no major complications.

Conclusion: These preliminary results suggest that flexible, covered stents may provide effective palliation of malignant anastomotic stricture secondary to recurrent gastric cancer.

Key words

Stenosis or obstruction Stomach Intestine Gastrointestinal tract, interventional procedure 

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References

  1. 1.
    Meijer S, DeBakker OJGB, Hoitsmer HFW (1983) Palliative resection in gastric cancer. J Surg Oncol 23:77–80PubMedCrossRefGoogle Scholar
  2. 2.
    Weaver DW, Wincek RG, Bouwman DL, Walt AJ (1987) Gastrojejunostomy: Is it helpful for patients with pancreatic cancer? Surgery 102:608–613PubMedGoogle Scholar
  3. 3.
    Spinelli P, Cerrai FG, Dal Fante M (1993) Endoscopic treatment of upper gastrointestinal tract malignancies. Endoscopy 25:675–678PubMedCrossRefGoogle Scholar
  4. 4.
    Song HY, Do YS, Han YM, Sung KB, Choi EK, Sohn KH, Kim HR, Kim SH, Min YI (1994) Covered esophageal metallic stent tubes: Experience in 119 patients. Radiology 193:689–695PubMedGoogle Scholar
  5. 5.
    Truong S, Bohndorf V, Geller H, Schumpelick V, Gunther RW (1992) Self-expanding metal stents for palliation of malignant gastric outlet obstruction. Endoscopy 24:433–455PubMedCrossRefGoogle Scholar
  6. 6.
    Strecker ED, Boos I, Husfeldt KJ (1995) Malignant duodenal stenosis: Palliation with peroral implantation of a self-expanding Nitinol stent. Radiology 196:349–351PubMedGoogle Scholar
  7. 7.
    Pinto IT (1997) Malignant gastric and duodenal stenosis: Palliation by peroral implantation of a self-expanding metallic stent. Cardiovasc Intervent Radiol 20:431–434PubMedCrossRefGoogle Scholar
  8. 8.
    Venu RP, Pastika BJ, Kini M, Chua D, Christian R, Schiais J, Brown RD (1998) Self-expandable metal stents for malignant gastric outlet obstruction: A modified technique. Endoscopy 30:553–558PubMedCrossRefGoogle Scholar
  9. 9.
    Patton JT, Carter R (1997) Endoscopic stenting for recurrent malignant gastric outlet obstruction. Br J Surg 84:865–866PubMedCrossRefGoogle Scholar
  10. 10.
    Wayman J, Bliss R, Richardson DL, Griffin SM (1998) Self-expanding metal stents in the palliation of small bowel stenosis secondary to recurrent gastric cancer. Gastrointest Endose 47:286–290CrossRefGoogle Scholar
  11. 11.
    Yates MR 3rd, Morgan DE, Baron TH (1998) Palliation of malignant gastric and small intestinal strictures with self-expandable metal stents. Endoscopy 30:266–272PubMedCrossRefGoogle Scholar
  12. 12.
    Park HS, Do YS, Suh SW, Choo SW, Lim HK, Kim SH, Shim YM, Park KC, Choo IW (1999) Upper gastrointestinal tract malignant obstruction: Initial results of palliation with a flexible covered stent. Radiology 210:865–870PubMedGoogle Scholar
  13. 13.
    Song HY, Park SI, Jung HY, Kim SB, Kim JH, Huh SJ, Kim TH, Kim YK, Park S, Yoon HK, Sung KB, Min YI (1997) Benign and malignant esophageal strictures: Treatment with a polyurethane-covered retrievable expandable metallic stent. Radiology 203:747–752PubMedGoogle Scholar
  14. 14.
    de Baere T, Harry G, Ducreux M, Elias D, Briquet R, Kuoch V, Roche A (1997) Self-expandable metallic stents as palliative treatment of malignant gastroduodenal stenosis. AJR 169:1079–1083PubMedGoogle Scholar
  15. 15.
    Song HY, Yang DH, Kuh JH, Choi KC (1995) Obstructing cancer of the gastric antrum: Palliative treatment with covered metallic stents. Radiology 196:349–351Google Scholar
  16. 16.
    Wayman J, Bliss R, Richardson DL, Griffin SM (1998) Self-expanding metal stents in the palliation of small bowel stenosis secondary to recurrent gastric cancer. Gastrointest Endose 47:286–290CrossRefGoogle Scholar
  17. 17.
    Binkert CA, Jost R, Steiner A, Zollikofer CL (1996) Benign and malignant stenoses of the stomach and duodenum: Treatment with self-expanding metallic endoprostheses. Radiology 199:335–358PubMedGoogle Scholar
  18. 18.
    Nevitt AW, Vida E, Kozarek RA, Traverso LW, Raltz SL (1998) Expandable metallic prosthesis for malignant obstructions of gastric outlet and proximal small bowel. Gastrointest Endose 47:271–276CrossRefGoogle Scholar

Copyright information

© Springer-Verlag New York, Inc 2001

Authors and Affiliations

  • Jeong-Min Lee
    • 1
    Email author
  • Young Min Han
    • 1
  • Sang Yong Lee
    • 1
  • Chong Soo Kim
    • 1
  • Doo Hyun Yang
    • 2
  • Seung Ok Lee
    • 3
  1. 1.Department of Diagnostic RadiologyChonbuk National University HospitalChonbukKorea
  2. 2.Department of General SurgeryChonbuk National University HospitalChonbukKorea
  3. 3.Department of internal MedicineChonbuk National University HospitalChonbukKorea

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