SEMS vs cSEMS in duodenal and small bowel obstruction : high risk of migration in the covered stent group

Aim: To compare clinical success and complications of uncovered self-expanding metal stents (SEMS) vs covered SEMS (cSEMS) in obstruction of the small bowel.
Methods: Technical success, complications and outcome of endo
Aim: To compare clinical success and complications of uncovered self-expanding metal stents (SEMS) vs covered SEMS (cSEMS) in obstruction of the small bowel.
Methods: Technical success, complications and outcome of endoscopic SEMS or cSEMS placement in tumor related obstruction of the duodenum or jejunum were retrospectively assessed. The primary end points were rates of stent migration and overgrowth. Secondary end points were the effect of concomitant biliary drainage on migration rate and overall survival. The data was analyzed according to the Strengthening the Reporting of Observational Studies in Epidemiology guidelines.
Results: Thirty-two SEMS were implanted in 20 patients. In all patients, endoscopic stent implantation was successful. Stent migration was observed in 9 of 16 cSEMS (56%) in comparison to 0/16 SEMS (0%) implantations (P = 0.002). Stent overgrowth did not significantly differ between the two stent types (SEMS: 3/16, 19%; cSEMS: 2/16, 13%). One cSEMS dislodged and had to be recovered from the jejunum by way of laparotomy. Time until migration between SEMS and cSEMS in patients with and without concomitant biliary stents did not significantly differ (HR = 1.530, 95%CI 0.731-6.306; P = 0.556). The mean follow-up was 57 ± 71 d (range: 1-275 d).
Conclusion: SEMS and cSEMS placement is safe in small bowel tumor obstruction. However, cSEMS is accompanied with a high rate of migration in comparison to uncovered SEMS.
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Author:Oliver Waidmann, Jörg Trojan, Mireen Friedrich-Rust, Christoph Sarrazin, Wolf Otto Bechstein, Frank Ulrich, Stefan Zeuzem, Jörg Gerhard Albert
URN:urn:nbn:de:hebis:30:3-320055
DOI:http://dx.doi.org/10.3748/wjg.v19.i37.6199
ISSN:2219-2840
ISSN:1007-9327
Pubmed Id:http://www.ncbi.nlm.nih.gov/pubmed?term=24115817
Parent Title (English):World journal of gastroenterology
Publisher:WJG Press
Place of publication:Beijing
Document Type:Article
Language:English
Date of Publication (online):2013/10/21
Date of first Publication:2013/10/07
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2013/10/21
Tag:Digestive system; Endoscopy; Intestinal neoplasms; Self-expandable metal stents; Self-expandable metal stents complications; Tumor obstruction
Volume:19
Issue:37
Pagenumber:9
First Page:6199
Last Page:6206
Note:
© 1995-2013 Baishideng Publishing Group Co., Limited. Articles published by this Open-Access journal are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license.
HeBIS PPN:362997276
Institutes:Medizin
Dewey Decimal Classification:610 Medizin und Gesundheit
Sammlungen:Universitätspublikationen
Licence (German):License LogoCreative Commons - Namensnennung-Nicht kommerziell 3.0

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