Journal article
Improved Oral Intake After Palliative Duodenal Stenting for Malignant Obstruction: A Prospective Multicenter Clinical Trial
The American journal of gastroenterology, Vol.104(10), pp.2404-2411
2009
DOI: 10.1038/ajg.2009.409
PMID: 19707192
Abstract
OBJECTIVES:
We sought to test the hypothesis that placement of a new nitinol duodenal self-expandable metallic stent (SEMS) for palliation of malignant gastroduodenal obstruction is effective and safe in allowing patients to tolerate an oral diet.
METHODS:
In a prospective multicenter study, SEMSs (Duodenal WallFlex, Boston Scientific) were placed to alleviate gastroduodenal obstruction in inoperable patients without the ability to tolerate solid food. The primary study end point was improvement in oral intake monitored according to the 4-point Gastric Outlet Obstruction Scoring System (GOOSS) up to 24 weeks after stent placement.
RESULTS:
Forty-three patients received SEMSs, which were successfully deployed on the first attempt in 41 cases (95%) and the second attempt in two (5%). Within 1 day and 7 days after SEMS placement, 52% and 75% of patients, respectively, benefited from a GOOSS increase ≥1. Resumption of solid food intake (GOOSS 2-3) was attained by 56% of patients within 7 days and 80% by 28 days. Of the patients attaining GOOSS 2-3, 48% remained on solid food until death or last follow-up. Device-related adverse events included stent occlusion/malfunction in 9% of patients and perforation in 5% of patients.
CONCLUSIONS:
Duodenal WallFlex stent placement promptly improves oral intake in a majority of inoperable patients with malignant gastroduodenal obstruction. In approximately half the patients achieving GOOSS 2-3, the capacity for solid food intake endures until death or last follow-up.
Details
- Title: Subtitle
- Improved Oral Intake After Palliative Duodenal Stenting for Malignant Obstruction: A Prospective Multicenter Clinical Trial
- Creators
- Michael PIESMAN - Endoscopy Center, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United StatesRichard A KOZAREK - Section of Gastroenterology, Virginia Mason Medical Center, Seattle, Washington, United StatesTodd H BARON - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United StatesWillis G PARSONS - Division of Gastroenterology, Department of Medicine, Northwestern University Medical School, Chicago, Illinois, United StatesAdam SLIVKA - Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United StatesDavid L CARR-LOCKE - Endoscopy Center, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United StatesJohn J BRANDABUR - Section of Gastroenterology, Virginia Mason Medical Center, Seattle, Washington, United StatesDouglas K PLESKOW - Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United StatesRam CHUTTANI - Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United StatesViktor E EYSSELEIN - Division of Gastroenterology, Harbor-UCLA Medical Center, Torrance, California, United StatesWilliam B SILVERMAN - Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, United StatesJohn J VARGO - Department of Gastroenterology, Cleveland Clinic Foundation, Cleveland, Ohio, United StatesIrving WAXMAN - Center for Advanced Medicine, University of Chicago Medical Center, Chicago, Illinois, United StatesMarc F CATALANO - Gastroenterology Consultants Ltd., Milwaukee, Wisconsin, United States
- Resource Type
- Journal article
- Publication Details
- The American journal of gastroenterology, Vol.104(10), pp.2404-2411
- Publisher
- Nature Publishing Group
- DOI
- 10.1038/ajg.2009.409
- PMID
- 19707192
- ISSN
- 0002-9270
- eISSN
- 1572-0241
- Language
- English
- Date published
- 2009
- Academic Unit
- Gastroenterology and Hepatology; Internal Medicine
- Record Identifier
- 9984094400702771
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