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3D-printed phantom study for investigating stent abutment during gastroduodenal stent placement for gastric outlet obstruction

BACKGROUND: Placing a self-expandable metallic stent (SEMS) is safe and effective for the palliative treatment of malignant gastroduodenal (GD) strictures. SEMS abutment in the duodenal wall is associated with increased food impaction, resulting in higher stent malfunction and shorter stent patency....

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Autores principales: Kim, Guk Bae, Park, Jung-Hoon, Song, Ho-Young, Kim, Namkug, Song, Hyun Kyung, Kim, Min Tae, Kim, Kun Yung, Tsauo, Jiaywei, Jun, Eun Jung, Kim, Do Hoon, Lee, Gin Hyug
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5954787/
https://www.ncbi.nlm.nih.gov/pubmed/29782574
http://dx.doi.org/10.1186/s41205-017-0017-0
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author Kim, Guk Bae
Park, Jung-Hoon
Song, Ho-Young
Kim, Namkug
Song, Hyun Kyung
Kim, Min Tae
Kim, Kun Yung
Tsauo, Jiaywei
Jun, Eun Jung
Kim, Do Hoon
Lee, Gin Hyug
author_facet Kim, Guk Bae
Park, Jung-Hoon
Song, Ho-Young
Kim, Namkug
Song, Hyun Kyung
Kim, Min Tae
Kim, Kun Yung
Tsauo, Jiaywei
Jun, Eun Jung
Kim, Do Hoon
Lee, Gin Hyug
author_sort Kim, Guk Bae
collection PubMed
description BACKGROUND: Placing a self-expandable metallic stent (SEMS) is safe and effective for the palliative treatment of malignant gastroduodenal (GD) strictures. SEMS abutment in the duodenal wall is associated with increased food impaction, resulting in higher stent malfunction and shorter stent patency. The desire to evaluate the mechanism and significance of stent abutment led us to design an in vitro experiment using a flexible anthropomorphic three-dimensional (3D)-printed GD phantom model. RESULTS: A GD phantom was fabricated using 3D printer data after performing computed tomography gastrography. A partially covered (PC) or fully covered (FC) stent was placed so that its distal end abutted onto the duodenal wall in groups PC-1 and FC-1 or its distal end was sufficiently directed caudally in groups PC-2 and FC-2. The elapsed times of the inflowing of three diets (liquid, soft, and solid) were measured in the GD phantom under fluoroscopic guidance. There was no significant difference in the mean elapsed times for the liquid diet among the four groups. For the soft diet, the mean elapsed times in groups PC-1 and FC-1 were longer than those in groups PC-2 and FC-2 (P = 0.018 and P < 0.001, respectively). For the solid diet, the mean elapsed time in group PC-1 was longer than that in group PC-2 (P < 0.001). The solid diet could not pass in group FC-1 due to food impaction. The mean elapsed times were significantly longer in groups FC-1 and FC-2 than in groups PC-1 and PC-2 for soft and solid diets (all P < 0.001). CONCLUSIONS: This flexible anthropomorphic 3D–printed GD phantom study revealed that stent abutment can cause prolonged passage of soft and solid diets through the stent as well as impaction of solid diets into the stent.
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spelling pubmed-59547872018-05-18 3D-printed phantom study for investigating stent abutment during gastroduodenal stent placement for gastric outlet obstruction Kim, Guk Bae Park, Jung-Hoon Song, Ho-Young Kim, Namkug Song, Hyun Kyung Kim, Min Tae Kim, Kun Yung Tsauo, Jiaywei Jun, Eun Jung Kim, Do Hoon Lee, Gin Hyug 3D Print Med Research BACKGROUND: Placing a self-expandable metallic stent (SEMS) is safe and effective for the palliative treatment of malignant gastroduodenal (GD) strictures. SEMS abutment in the duodenal wall is associated with increased food impaction, resulting in higher stent malfunction and shorter stent patency. The desire to evaluate the mechanism and significance of stent abutment led us to design an in vitro experiment using a flexible anthropomorphic three-dimensional (3D)-printed GD phantom model. RESULTS: A GD phantom was fabricated using 3D printer data after performing computed tomography gastrography. A partially covered (PC) or fully covered (FC) stent was placed so that its distal end abutted onto the duodenal wall in groups PC-1 and FC-1 or its distal end was sufficiently directed caudally in groups PC-2 and FC-2. The elapsed times of the inflowing of three diets (liquid, soft, and solid) were measured in the GD phantom under fluoroscopic guidance. There was no significant difference in the mean elapsed times for the liquid diet among the four groups. For the soft diet, the mean elapsed times in groups PC-1 and FC-1 were longer than those in groups PC-2 and FC-2 (P = 0.018 and P < 0.001, respectively). For the solid diet, the mean elapsed time in group PC-1 was longer than that in group PC-2 (P < 0.001). The solid diet could not pass in group FC-1 due to food impaction. The mean elapsed times were significantly longer in groups FC-1 and FC-2 than in groups PC-1 and PC-2 for soft and solid diets (all P < 0.001). CONCLUSIONS: This flexible anthropomorphic 3D–printed GD phantom study revealed that stent abutment can cause prolonged passage of soft and solid diets through the stent as well as impaction of solid diets into the stent. Springer International Publishing 2017-09-25 /pmc/articles/PMC5954787/ /pubmed/29782574 http://dx.doi.org/10.1186/s41205-017-0017-0 Text en © The Author(s) 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Research
Kim, Guk Bae
Park, Jung-Hoon
Song, Ho-Young
Kim, Namkug
Song, Hyun Kyung
Kim, Min Tae
Kim, Kun Yung
Tsauo, Jiaywei
Jun, Eun Jung
Kim, Do Hoon
Lee, Gin Hyug
3D-printed phantom study for investigating stent abutment during gastroduodenal stent placement for gastric outlet obstruction
title 3D-printed phantom study for investigating stent abutment during gastroduodenal stent placement for gastric outlet obstruction
title_full 3D-printed phantom study for investigating stent abutment during gastroduodenal stent placement for gastric outlet obstruction
title_fullStr 3D-printed phantom study for investigating stent abutment during gastroduodenal stent placement for gastric outlet obstruction
title_full_unstemmed 3D-printed phantom study for investigating stent abutment during gastroduodenal stent placement for gastric outlet obstruction
title_short 3D-printed phantom study for investigating stent abutment during gastroduodenal stent placement for gastric outlet obstruction
title_sort 3d-printed phantom study for investigating stent abutment during gastroduodenal stent placement for gastric outlet obstruction
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5954787/
https://www.ncbi.nlm.nih.gov/pubmed/29782574
http://dx.doi.org/10.1186/s41205-017-0017-0
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