Clinical outcomes of self-expandable metal stents in palliation of malignant anastomotic strictures caused by recurrent gastric cancer

摘要

AIM:To examine the technical feasibility and clinical outcomes of the endoscopic insertion of a self-expandable metal stent(SEMS) for the palliation of a malignant anastomotic stricture caused by recurrent gastric cancer.METHODS:The medical records of patients, who had obstructive symptoms caused by a malignant anastomotic stricture after gastric surgery and underwent endoscopic insertion of a SEMS from January 2001 to December 2007 at Kangnam St Mary's Hospital, were reviewed retrospectively.RESULTS:Twenty patients(15 male, mean age 63 years) were included.The operations were a total gastrectomy with esophagojejunostomy(n = 12), subtotal gastrectomy with Billroth-—migration occurred with a covered stent in 3 patients who underwent a subtotal gastrectomy with Billroth-reconstruction.Two cases of partial stent migration were easily treated with a second stent or stent repositioning.The median stent patency was 56 d(range, 5-439 d).The median survival was 83 d(range, 12-439 d).CONCLUSION:Endoscopic insertion of a SEMS provides safe and effective palliation of a recurrent anastomotic stricture caused by gastric cancer.A meticulous evaluation of the presence of other strictures before inserting the stent is essential for symptom improvement.