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Gastrointestinal Luminal Stenting

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Geriatric Gastroenterology

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Abstract

Gastrointestinal (GI) stenting has advanced rapidly in recent years and has emerged as an essential alternative to surgery especially in patients with malignant obstruction or strictures of the GI tract. In addition to malignancy, GI stenting is expanded to several other non-malignant indications. Future development of stents with bigger diameter may be useful in other conditions such as achalasia. Operator expertise and a better understanding of the stent characteristics may result in optimal placement and decreased complications. As advancing age is a known risk factor for cancers in general, older adults who develop malignant obstruction and strictures in the GI tract are commonly encountered in clinical practice. In those, luminal stenting remains a valuable and minimally invasive palliative option. Patients highly desire the restoration of oral nutrition, which can be achieved by GI luminal stenting in the majority of cases, and relief of obstruction results in significant improvement in the quality of life.

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References

  • Adler DG, Baron TH. Endoscopic palliation of malignant gastric outlet obstruction using self-expanding metal stents: experience in 36 patients. Am J Gastroenterol. 2002;97:72–8.

    Article  Google Scholar 

  • Baron TH, Siersema PD. Stents for the gastrointestinal tract. Endoscopy. 2019;51:611–2.

    Article  Google Scholar 

  • Brimhall B, Adler DG. Enteral stents for malignant gastric outlet obstruction. Gastrointest Endosc Clin N Am. 2011;21:389–403.

    Article  Google Scholar 

  • Brouwer R, Macdonald A, Matthews R, Gunn J, Monson JR, Hartley JE. Brush cytology for the diagnosis of colorectal cancer. Dis Colon Rectum. 2009;52:598–601.

    Article  Google Scholar 

  • Castaño R, Lopes TL, Alvarez O, Calvo V, Luz LP, Artifon EL. Nitinol biliary stent versus surgery for palliation of distal malignant biliary obstruction. Surg Endosc. 2010;24:2092–8.

    Article  Google Scholar 

  • Chen YI, Itoi T, Baron TH, Nieto J, Haito-Chavez Y, Grimm IS, Ismail A, Ngamruengphong S, Bukhari M, Hajiyeva G, Alawad AS, Kumbhari V, Khashab MA. EUS-guided gastroenterostomy is comparable to enteral stenting with fewer re-interventions in malignant gastric outlet obstruction. Surg Endosc. 2017;31:2946–52.

    Article  Google Scholar 

  • Cheynel N, Cortet M, Lepage C, Benoit L, Faivre J, Bouvier AM. Trends in frequency and management of obstructing colorectal cancers in a well-defined population. Dis Colon Rectum. 2007;50:1568–75.

    Article  Google Scholar 

  • Del Piano M, Ballarè M, Montino F, Todesco A, Orsello M, Magnani C, Garello E. Endoscopy or surgery for malignant GI outlet obstruction? Gastrointest Endosc. 2005;61:421–6.

    Article  Google Scholar 

  • Dollhopf M, Larghi A, Will U, Rimbaş M, Anderloni A, Sanchez-Yague A, Teoh AYB, Kunda R. EUS-guided gallbladder drainage in patients with acute cholecystitis and high surgical risk using an electrocautery-enhanced lumen-apposing metal stent device. Gastrointest Endosc 2017;86:636–43.

    Google Scholar 

  • Dormann AJ, Eisendrath P, Wigginghaus B, Huchzermeyer H, Devière J. Palliation of esophageal carcinoma with a new self-expanding plastic stent. Endoscopy. 2003;35:207–11.

    Article  CAS  Google Scholar 

  • Faraz S, Salem SB, Schattner M, Mendelsohn R, Markowitz A, Ludwig E, Zheng J, Gerdes H, Shah PM. Predictors of clinical outcome of colonic stents in patients with malignant large-bowel obstruction because of extracolonic malignancy. Gastrointest Endosc. 2018;87:1310–7.

    Article  Google Scholar 

  • Frager D, Rovno HD, Baer JW, Bashist B, Friedman M. Prospective evaluation of colonic obstruction with computed tomography. Abdom Imaging. 1998;23:141–6.

    Article  CAS  Google Scholar 

  • Frago R, Ramirez E, Millan M, Kreisler E, Del Valle E, Biondo S. Current management of acute malignant large bowel obstruction: a systematic review. Am J Surg. 2014;207:127–38.

    Article  Google Scholar 

  • Frimberger E. Expanding spiral--a new type of prosthesis for the palliative treatment of malignant esophageal stenoses. Endoscopy. 1983;15(Suppl 1):213–4.

    Article  Google Scholar 

  • Hirdes MM, Vleggaar FP, De Beule M, Siersema PD. In vitro evaluation of the radial and axial force of self-expanding esophageal stents. Endoscopy. 2013;45:997–1005.

    Article  Google Scholar 

  • Homs MY, Steyerberg EW, Eijkenboom WM, Tilanus HW, Stalpers LJ, Bartelsman JF, Van Lanschot JJ, Wijrdeman HK, Mulder CJ, Reinders JG, Boot H, Aleman BM, Kuipers EJ, Siersema PD. Single-dose brachytherapy versus metal stent placement for the palliation of dysphagia from oesophageal cancer: multicentre randomised trial. Lancet. 2004;364:1497–504.

    Article  Google Scholar 

  • Jeurnink SM, Van Eijck CH, Steyerberg EW, Kuipers EJ, Siersema PD. Stent versus gastrojejunostomy for the palliation of gastric outlet obstruction: a systematic review. BMC Gastroenterol. 2007;7:18.

    Article  Google Scholar 

  • Jullumstrø E, Wibe A, Lydersen S, Edna TH. Colon cancer incidence, presentation, treatment and outcomes over 25 years. Color Dis. 2011;13:512–8.

    Article  Google Scholar 

  • Khashab M, Alawad AS, Shin EJ, Kim K, Bourdel N, Singh VK, Lennon AM, Hutfless S, Sharaiha RZ, Amateau S, Okolo PI, Makary MA, Wolfgang C, Canto MI, Kalloo AN. Enteral stenting versus gastrojejunostomy for palliation of malignant gastric outlet obstruction. Surg Endosc. 2013;27:2068–75.

    Article  Google Scholar 

  • Kochman ML, Mcclave SA, Boyce HW. The refractory and the recurrent esophageal stricture: a definition. Gastrointest Endosc. 2005;62:474–5.

    Article  Google Scholar 

  • Mudumbi S, Velazquez-Aviña J, Neumann H, Kyanam Kabir Baig KR, Mönkemüller K. Anchoring of self-expanding metal stents using the over-the-scope clip, and a technique for subsequent removal. Endoscopy. 2014;46:1106–9.

    Article  Google Scholar 

  • Mussetto A, Fugazza A, Fuccio L, Triossi O, Repici A, Anderloni A. Current uses and outcomes of lumen-apposing metal stents. Ann Gastroenterol 2018;31:535–40.

    Google Scholar 

  • Ormando VM, Palma R, Fugazza A, Repici A. Colonic stents for malignant bowel obstruction: current status and future prospects. Expert Rev Med Devices. 2019;16:1053–61.

    Article  CAS  Google Scholar 

  • Reijm AN, Didden P, Schelling SJC, Siersema PD, Bruno MJ, Spaander MCW. Self-expandable metal stent placement for malignant esophageal strictures - changes in clinical outcomes over time. Endoscopy. 2019;51:18–29.

    Article  Google Scholar 

  • Repici A, Small AJ, Mendelson A, Jovani M, Correale L, Hassan C, Ridola L, Anderloni A, Ferrara EC, Kochman ML. Natural history and management of refractory benign esophageal strictures. Gastrointest Endosc. 2016;84:222–8.

    Article  Google Scholar 

  • Sabharwal T, Hamady MS, Chui S, Atkinson S, Mason R, Adam A. A randomised prospective comparison of the flamingo Wallstent and Ultraflex stent for palliation of dysphagia associated with lower third oesophageal carcinoma. Gut. 2003;52:922–6.

    Article  CAS  Google Scholar 

  • Sabharwal T, Morales JP, Irani FG, Adam A. Quality improvement guidelines for placement of esophageal stents. Cardiovasc Intervent Radiol. 2005;28:284–8.

    Article  Google Scholar 

  • Sebastian S, Johnston S, Geoghegan T, Torreggiani W, Buckley M. Pooled analysis of the efficacy and safety of self-expanding metal stenting in malignant colorectal obstruction. Am J Gastroenterol. 2004;99:2051–7.

    Article  Google Scholar 

  • Spaander MC, Baron TH, Siersema PD, Fuccio L, Schumacher B, Escorsell À, Garcia-Pagán JC, Dumonceau JM, Conio M, De Ceglie A, Skowronek J, Nordsmark M, Seufferlein T, Van Gossum A, Hassan C, Repici A, Bruno MJ. Esophageal stenting for benign and malignant disease: European Society of Gastrointestinal Endoscopy (ESGE) clinical guideline. Endoscopy. 2016;48:939–48.

    Article  Google Scholar 

  • Symonds CJ. The treatment of malignant stricture of the OEsophagus by Tubage or permanent Catheterism. Br Med J. 1887;1:870–3.

    Article  CAS  Google Scholar 

  • Tyberg A, Perez-Miranda M, Sanchez-Ocaña R, Peñas I, De La Serna C, Shah J, Binmoeller K, Gaidhane M, Grimm I, Baron T, Kahaleh M. Endoscopic ultrasound-guided gastrojejunostomy with a lumen-apposing metal stent: a multicenter, international experience. Endosc Int Open. 2016;4:E276–81.

    Google Scholar 

  • Van Hooft JE, Van Halsema EE, Vanbiervliet G, Beets-Tan RG, Dewitt JM, Donnellan F, Dumonceau JM, Glynne-Jones RG, Hassan C, Jiménez-Perez J, Meisner S, Muthusamy VR, Parker MC, Regimbeau JM, Sabbagh C, Sagar J, Tanis PJ, Vandervoort J, Webster GJ, Manes G, Barthet MA, Repici A. Self-expandable metal stents for obstructing colonic and extracolonic cancer: European Society of Gastrointestinal Endoscopy (Esge) clinical guideline. Endoscopy. 2014;46:990–1053.

    Article  Google Scholar 

  • Van Hooft JE, Veld JV, Arnold D, Beets-Tan RGH, Everett S, Götz M, Van Halsema EE, Hill J, Manes G, Meisner S, Rodrigues-Pinto E, Sabbagh C, Vandervoort J, Tanis PJ, Vanbiervliet G, Arezzo A. Self-expandable metal stents for obstructing colonic and extracolonic cancer: European Society of Gastrointestinal Endoscopy (ESGE) guideline - update 2020. Endoscopy. 2020;52:389–407.

    Article  Google Scholar 

  • Varadarajulu S, Banerjee S, Barth B, Desilets D, Kaul V, Kethu S, Pedrosa M, Pfau P, Tokar J, Wang A, Song LM, Rodriguez S. Enteral stents. Gastrointest Endosc. 2011;74:455–64.

    Article  Google Scholar 

  • Vermeulen BD, Siersema PD. Esophageal stenting in clinical practice: an overview. Curr Treat Options Gastroenterol. 2018;16:260–73.

    Article  Google Scholar 

  • Wai CT, Ho KY, Yeoh KG, Lim SG. Palliation of malignant gastric outlet obstruction caused by gastric cancer with self-expandable metal stents. Surg Laparosc Endosc Percutan Tech. 2001;11:161–4.

    Article  CAS  Google Scholar 

  • Walter D, Van Den Berg MW, Van Hooft JE, Boot H, Scheffer RC, Vleggaar FP, Siersema PD. A new fully covered metal stent with anti-migration features for the treatment of malignant dysphagia. Endoscopy. 2014;46:1101–5.

    Article  Google Scholar 

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Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, Saint Peter’s University Hospital, New Brunswick, NJ, USA

    Chiranjeevi Gadiparthi & Andrew Korman

Authors
  1. Chiranjeevi Gadiparthi
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  2. Andrew Korman
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Corresponding author

Correspondence to Andrew Korman .

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Editors and Affiliations

  1. Department of Medicine, Robert Wood Johnson School of Medicine, Rutgers University, New Brunswick, NJ, USA

    C. S. Pitchumoni

  2. Department of Medicine, Division of Geriatrics, Montefiore Medical Center, Wakefield Campus, Bronx, NY, USA

    T.S. Dharmarajan

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Gadiparthi, C., Korman, A. (2021). Gastrointestinal Luminal Stenting. In: Pitchumoni, C.S., Dharmarajan, T. (eds) Geriatric Gastroenterology. Springer, Cham. https://doi.org/10.1007/978-3-030-30192-7_32

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  • DOI: https://doi.org/10.1007/978-3-030-30192-7_32

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-30191-0

  • Online ISBN: 978-3-030-30192-7

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