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.