| Efficacy and safety of the new WallFlex enteral stent in palliative treatment of malignant gastric outlet obstruction (DUOFLEX study): a prospective multicenter study. | |
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MedLine Citation:
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PMID: 19152912 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Gastric outlet obstruction (GOO) is most commonly a complication of advanced distal gastric, periampullary, or duodenal malignancy. Palliation of obstruction is the primary aim of treatment in most of these patients. Self-expandable metal stents have emerged as an effective treatment option. OBJECTIVE: Our purpose was to investigate the efficacy and safety of a newly developed enteral metal stent (WallFlex). DESIGN: Prospective multicenter cohort study. SETTING: Three tertiary referral centers (2 academic). PATIENTS: Fifty-one consecutive patients with symptomatic malignant GOO from January 2005 to February 2006. INTERVENTION: Placement of a self-expandable metallic stent (WallFlex). MAIN OUTCOME MEASUREMENTS: The primary end point was defined as improvement of the GOO scoring system for the remainder of the patients' lives. Secondary end points focused on efficacy and safety and global quality of life. RESULTS: The Gastric Outlet Obstruction Scoring System score improved (P < .001), the body mass index decreased (P < .001), and the World Health Organization performance score improved (P = .002) when the score before stenting was compared with the mean score until death. Global quality of life did not improve. Technical and clinical success was achieved in 98% and 84% of the patients. Median survival was 62 days (75% alive at 35 days, 25% alive at 156 days). Median stent patency was 307 days (75% functional at 135 days, 25% functional at 470 days). Stent dysfunction was proved in 7 patients (14%), migration in 1 (2%), and tumor overgrowth or ingrowth in 6 (12%). LIMITATIONS: Lack of a control group. CONCLUSION: Placement of a WallFlex enteral stent in patients with nonresectable malignant GOO is safe and provides a statistically significant and clinically relevant relief of obstructive symptoms with a low need for reintervention. |
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Authors:
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Jeanin E van Hooft; Madeleen J Uitdehaag; Marco J Bruno; Robin Timmer; Peter D Siersema; Marcel G W Dijkgraaf; Paul Fockens |
Publication Detail:
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Type: Journal Article; Multicenter Study Date: 2009-01-18 |
Journal Detail:
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Title: Gastrointestinal endoscopy Volume: 69 ISSN: 1097-6779 ISO Abbreviation: Gastrointest. Endosc. Publication Date: 2009 May |
Date Detail:
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Created Date: 2009-05-04 Completed Date: 2009-08-06 Revised Date: 2010-09-03 |
Medline Journal Info:
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Nlm Unique ID: 0010505 Medline TA: Gastrointest Endosc Country: United States |
Other Details:
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Languages: eng Pagination: 1059-66 Citation Subset: IM |
Affiliation:
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Academic Medical Center, Amsterdam, Netherlands. j.e.vanhooft@amc.nl |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Activities of Daily Living
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classification Aged Aged, 80 and over Ampulla of Vater* Body Mass Index Cholangiocarcinoma / mortality, therapy* Cohort Studies Common Bile Duct Neoplasms / mortality, therapy* Duodenal Neoplasms / mortality, therapy* Equipment Failure Analysis Equipment Safety Female Follow-Up Studies Gastric Outlet Obstruction / mortality, therapy* Humans Male Middle Aged Palliative Care / methods* Pancreatic Neoplasms / mortality, therapy* Prospective Studies Stents* Stomach Neoplasms / mortality, therapy* Survival Analysis Treatment Outcome |
| Comments/Corrections | |
Comment In:
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Gastrointest Endosc. 2010 Jan;71(1):220-1
[PMID:
20105481
]
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Erratum In:
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Gastrointest Endosc. 2010 Sep;72(3):674 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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