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

BACKGROUND: Through-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.

OBJECTIVES: To evaluate clinical experience with a new woven enteral stent in the treatment of gastric outlet obstruction.

DESIGN: From January 2005 to August 2006, patients with unresectable malignant gastric outlet obstruction were offered stent placement with a new woven stent.

SETTING: Three referral hospitals in Japan.

PATIENTS: Thirty-seven consecutive patients with malignant gastric outlet obstruction.

INTERVENTIONS: A newly designed enteral stent was placed by using the TTS placement technique.

MAIN OUTCOME MEASUREMENTS: Palliation efficacy and safety of the new stents.

RESULTS: Stent 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.

LIMITATIONS: Small sample size and relatively brief follow-up.

CONCLUSIONS: A 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.