Document Detail


Safety and efficacy of gastrointestinal stents in cancer patients at a community hospital.
MedLine Citation:
PMID:  18377754     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Increasing scientific evidence supports the use of self-expanding metallic gastrointestinal (GI) stents. The commonly accepted primary indications are their usefulness as a bridge to surgery and for palliation to avoid surgery. These stents have been shown to have high technical success and low complication rates, leading to improved quality of life for patients. They have also been shown to be cost-effective when compared with alternative therapies. The objective of this study is to present a retrospective review of our local experience. METHODS: Attempts were made to place 23 GI stents in 16 patients for palliative cancer indications. RESULTS: Follow-up was 5-352 days (mean 81.9 d). Presenting symptoms included abdominal distention or pain (81%), nausea or vomiting (69%), constipation (31%) and weight loss (19%). Stents were placed in the colon (11 patients), duodenum (4 patients) or esophagus (1 patient). The technical success rate was 91.3%, the clinical success rate (defined as any improvement in symptoms in patients successfully receiving a stent) was 85.7%, and the complication rate was 21.4% among patients successfully receiving a stent, or 18.8% overall. Of 14 patients successfully receiving at least 1 stent, 10 (71%) were discharged home after a mean of 11.5 days (range 1-26 d). Of patients successfully receiving at least 1 stent, 12 (86%) had passed away at the time of last follow-up. Patients who successfully received a stent but who have since passed away (either in hospital or out of hospital) had their stent(s) in situ for a mean of 57 days (range 5-180 d). CONCLUSION: On the basis of our data, we believe that GI stents may be safely and effectively used in a community hospital setting and that they provide benefit in the palliative care population.
Authors:
Mark Otto Baerlocher; Murray R Asch; Andrew Vellahottam; Gaurav Puri; Karen Andrews; Andy Myers
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Canadian journal of surgery. Journal canadien de chirurgie     Volume:  51     ISSN:  1488-2310     ISO Abbreviation:  Can J Surg     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-04-01     Completed Date:  2008-04-11     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0372715     Medline TA:  Can J Surg     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  130-4     Citation Subset:  IM    
Affiliation:
Radiology Residency Training Program, Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada. mark.baerlocher@utoronto.ca
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Colonic Neoplasms / mortality,  therapy*
Duodenal Neoplasms / mortality,  therapy*
Equipment Failure / statistics & numerical data
Equipment Safety*
Esophageal Neoplasms / mortality,  therapy*
Esophageal Stenosis / mortality,  therapy*
Female
Fluoroscopy
Follow-Up Studies
Hospital Mortality
Hospitals, Community / statistics & numerical data
Humans
Intestinal Obstruction / mortality,  therapy*
Length of Stay / statistics & numerical data
Male
Middle Aged
Ontario
Palliative Care*
Postoperative Complications / etiology*,  mortality
Radiology, Interventional*
Stents*
Survival Rate
Treatment Outcome
Comments/Corrections

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