Document Detail


Double layered self-expanding metal stents for malignant esophageal obstruction, especially across the gastroesophageal junction.
MedLine Citation:
PMID:  22851867     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To evaluate the clinical outcomes of double-layered self-expanding metal stents (SEMS) for treatment of malignant esophageal obstruction according to whether SEMS crosses the gastroesophageal junction (GEJ).
METHODS: Forty eight patients who underwent the SEMS insertion for malignant esophageal obstruction were enrolled. Patients were classified as GEJ group (SEMS across GEJ, 18 patients) and non-GEJ group (SEMS above GEJ, 30 patients) according to SEMS position. Double layered (outer uncovered and inner covered stent) esophageal stents were placed.
RESULTS: The SEMS insertion and the clinical improvement were achieved in all patients in both groups. Stent malfunction occurred in seven patients in the GEJ group and nine patients in the non-GEJ group. Tumor overgrowth occurred in five and eight patients, respectively, food impaction occurred in one patient in each group, and stent migration occurred in one and no patient, respectively. There were no significant differences between the two groups. Reflux esophagitis occurred more frequently in the GEJ group (eight vs five patients, P = 0.036) and was controlled by proton pump inhibitor. Aspiration pneumonia occurred in zero and five patients, respectively, and tracheoesophageal fistula occurred in zero and two patients, respectively.
CONCLUSION: Double-layered SEMS are a feasible and effective treatment when placed across the GEJ for malignant esophageal obstruction. Double-layered SEMS provide acceptable complications, especially migration, although reflux esophagitis is more common in the GEJ group.
Authors:
Min Dae Kim; Su Bum Park; Dae Hwan Kang; Jae Hyung Lee; Cheol Woong Choi; Hyung Wook Kim; Chung Uk Chung; Young Il Jeong
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  World journal of gastroenterology : WJG     Volume:  18     ISSN:  1007-9327     ISO Abbreviation:  World J. Gastroenterol.     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-08-01     Completed Date:  2013-01-10     Revised Date:  2013-07-12    
Medline Journal Info:
Nlm Unique ID:  100883448     Medline TA:  World J Gastroenterol     Country:  China    
Other Details:
Languages:  eng     Pagination:  3732-7     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Bongseng Memorial Hospital, Busan 601-723, South Korea.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Endoscopy / methods
Equipment Design
Esophageal Diseases / surgery*,  therapy
Esophageal Stenosis / surgery*,  therapy
Esophagitis, Peptic / surgery,  therapy*
Esophagogastric Junction / physiopathology,  surgery*
Female
Gastroenterology / methods
Humans
Male
Metals / chemistry*
Middle Aged
Stents*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Metals
Comments/Corrections

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