Palliation in patients with malignant gastric outlet obstruction with a newly designed enteral stent: a multicenter study

BackgroundThrough-the-scope (TTS) stents facilitate palliative enteral stent placement. However, most TTS stents are braided, a characteristic that has been associated with significant foreshortening and relatively frequent migration.ObjectivesTo evaluate clinical experience with a new woven enteral stent in the treatment of gastric outlet obstruction.DesignFrom January 2005 to August 2006, patients with unresectable malignant gastric outlet obstruction were offered stent placement with a new woven stent.SettingThree referral hospitals in Japan.PatientsThirty-seven consecutive patients with malignant gastric outlet obstruction.InterventionsA newly designed enteral stent was placed by using the TTS placement technique.Main Outcome MeasurementsPalliation efficacy and safety of the new stents.ResultsStent placement was successful in 36 of 37 patients (technical success, 97%). Thirty-four patients were able to tolerate oral intake without obstructive symptoms (clinical success, 94.4%). Complications occurred in 16.2% of patients, comprising 2 cases of primary stent dysfunction, 1 perforation, 1 GI bleeding, 1 stent obstruction, and 1 biliary stent dysfunction. No migration was seen during the median follow-up period of 68 days.LimitationsSmall sample size and relatively brief follow-up.ConclusionsA newly developed enteral stent with higher flexibility and less foreshortening offers comparable clinical outcome to existing stents and a lower frequency of complications, including migration.