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Palliation of malignant gastroduodenal obstruction with self‐expandable metal stent using side‐ and forward‐viewing endoscope: Feasibility and outcome
BACKGROUND: The endoscopic placement of a self‐expandable metal stent (SEMS), an alternative to surgical bypass for the palliation of malignant gastric outlet obstruction (GOO), is commonly performed using a forward‐viewing endoscope with a wide therapeutic channel; however, due to limited availabil...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wiley Publishing Asia Pty Ltd
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6386745/ https://www.ncbi.nlm.nih.gov/pubmed/30834343 http://dx.doi.org/10.1002/jgh3.12110 |
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author | Kumar, Vinay Ghoshal, Uday C Mohindra, Samir Saraswat, Vivek A |
author_facet | Kumar, Vinay Ghoshal, Uday C Mohindra, Samir Saraswat, Vivek A |
author_sort | Kumar, Vinay |
collection | PubMed |
description | BACKGROUND: The endoscopic placement of a self‐expandable metal stent (SEMS), an alternative to surgical bypass for the palliation of malignant gastric outlet obstruction (GOO), is commonly performed using a forward‐viewing endoscope with a wide therapeutic channel; however, due to limited availability, most Indian centers use a side‐viewing duodenoscope. We studied the feasibility and outcome of SEMS placement using side‐ and forward‐viewing endoscopes. METHOD: Data of patients undergoing SEMS placement using side‐ and forward‐viewing endoscopes with a therapeutic channel for the palliation of malignant GOO presenting during a 5‐year period were analyzed retrospectively. Follow‐up data were obtained from records and telephonic interviews, and technical and clinical success, complications, and survival were evaluated. RESULTS: Of 114 patients (age 56.5 ± 11.6 years, 59 [52%] female), 90 (79%) and 24 (21%) underwent SEMS placement using side‐ and forward‐viewing endoscopes, respectively. Technical (89, 98.9% vs. 24, 100%, P = ns) and clinical success (84, 93.3% vs. 23, 95.8%, P = ns) and complication rate (3, 3.3% vs. 0, P = ns) between side‐ and forward‐viewing endoscopes were comparable. However, SEMS could be placed in a shorter time using a forward‐ rather than side‐viewing endoscope (21 min [inter‐quartile range 19.5–35] vs. 34 min [25–45], P = < 0.001). SEMS could be deployed successfully with a forward‐viewing endoscope in two patients in whom an initial attempt using side‐viewing endoscope failed. Gastric outlet obstruction scoring system (GOOSS) improved following stent placement (median 0, range 0–2 vs. 2, 0–3, P = 0.0001). The survival of patients undergoing SEMS placement using side‐ and forward‐viewing endoscopes was comparable. CONCLUSION: Although side‐ and forward‐viewing endoscopes are equally effective for antroduodenal SEMS placement, the procedure can be performed faster using the latter. |
format | Online Article Text |
id | pubmed-6386745 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Wiley Publishing Asia Pty Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-63867452019-03-04 Palliation of malignant gastroduodenal obstruction with self‐expandable metal stent using side‐ and forward‐viewing endoscope: Feasibility and outcome Kumar, Vinay Ghoshal, Uday C Mohindra, Samir Saraswat, Vivek A JGH Open Original Articles BACKGROUND: The endoscopic placement of a self‐expandable metal stent (SEMS), an alternative to surgical bypass for the palliation of malignant gastric outlet obstruction (GOO), is commonly performed using a forward‐viewing endoscope with a wide therapeutic channel; however, due to limited availability, most Indian centers use a side‐viewing duodenoscope. We studied the feasibility and outcome of SEMS placement using side‐ and forward‐viewing endoscopes. METHOD: Data of patients undergoing SEMS placement using side‐ and forward‐viewing endoscopes with a therapeutic channel for the palliation of malignant GOO presenting during a 5‐year period were analyzed retrospectively. Follow‐up data were obtained from records and telephonic interviews, and technical and clinical success, complications, and survival were evaluated. RESULTS: Of 114 patients (age 56.5 ± 11.6 years, 59 [52%] female), 90 (79%) and 24 (21%) underwent SEMS placement using side‐ and forward‐viewing endoscopes, respectively. Technical (89, 98.9% vs. 24, 100%, P = ns) and clinical success (84, 93.3% vs. 23, 95.8%, P = ns) and complication rate (3, 3.3% vs. 0, P = ns) between side‐ and forward‐viewing endoscopes were comparable. However, SEMS could be placed in a shorter time using a forward‐ rather than side‐viewing endoscope (21 min [inter‐quartile range 19.5–35] vs. 34 min [25–45], P = < 0.001). SEMS could be deployed successfully with a forward‐viewing endoscope in two patients in whom an initial attempt using side‐viewing endoscope failed. Gastric outlet obstruction scoring system (GOOSS) improved following stent placement (median 0, range 0–2 vs. 2, 0–3, P = 0.0001). The survival of patients undergoing SEMS placement using side‐ and forward‐viewing endoscopes was comparable. CONCLUSION: Although side‐ and forward‐viewing endoscopes are equally effective for antroduodenal SEMS placement, the procedure can be performed faster using the latter. Wiley Publishing Asia Pty Ltd 2018-11-19 /pmc/articles/PMC6386745/ /pubmed/30834343 http://dx.doi.org/10.1002/jgh3.12110 Text en © 2018 The Authors. JGH Open: An open access journal of gastroenterology and hepatology published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | Original Articles Kumar, Vinay Ghoshal, Uday C Mohindra, Samir Saraswat, Vivek A Palliation of malignant gastroduodenal obstruction with self‐expandable metal stent using side‐ and forward‐viewing endoscope: Feasibility and outcome |
title | Palliation of malignant gastroduodenal obstruction with self‐expandable metal stent using side‐ and forward‐viewing endoscope: Feasibility and outcome |
title_full | Palliation of malignant gastroduodenal obstruction with self‐expandable metal stent using side‐ and forward‐viewing endoscope: Feasibility and outcome |
title_fullStr | Palliation of malignant gastroduodenal obstruction with self‐expandable metal stent using side‐ and forward‐viewing endoscope: Feasibility and outcome |
title_full_unstemmed | Palliation of malignant gastroduodenal obstruction with self‐expandable metal stent using side‐ and forward‐viewing endoscope: Feasibility and outcome |
title_short | Palliation of malignant gastroduodenal obstruction with self‐expandable metal stent using side‐ and forward‐viewing endoscope: Feasibility and outcome |
title_sort | palliation of malignant gastroduodenal obstruction with self‐expandable metal stent using side‐ and forward‐viewing endoscope: feasibility and outcome |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6386745/ https://www.ncbi.nlm.nih.gov/pubmed/30834343 http://dx.doi.org/10.1002/jgh3.12110 |
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