1. Stent under-expansion on the procedure day, a predictive factor for poor oral intake after metallic stenting for gastric outlet obstruction.
- Author
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Hori, Yasuki, Naitoh, Itaru, Ban, Tesshin, Narita, Kei, Nakazawa, Takahiro, Hayashi, Kazuki, Miyabe, Katsuyuki, Shimizu, Shuya, Kondo, Hiromu, Nishi, Yuji, Yoshida, Michihiro, Umemura, Shuichiro, Kato, Akihisa, Yamada, Tomonori, Ando, Tomoaki, and Joh, Takashi
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SURGICAL stents , *GASTRIC outlet obstruction , *EATING disorders , *PALLIATIVE treatment , *GASTROINTESTINAL system , *GASTRIC bypass , *GASTROENTEROSTOMY - Abstract
Background and Aim Self-expandable metallic stents ( SEMS) have been widely accepted as palliation therapy for malignant gastric outlet obstruction ( GOO). However, the factors predictive of poor oral intake after SEMS placement have not been elucidated sufficiently. We aimed to clarify both the patient and stent-related predictive factors. Methods We retrospectively reviewed 126 consecutive patients who underwent uncovered SEMS placement for malignant GOO between April 2010 and March 2013 at a university hospital and two tertiary care referral centers. Results Technical success of SEMS placement was achieved in all 126 (100%) patients. Improved oral intake was observed in 111 (88.1%) patients. A Karnofsky performance status ≤ 40 (odds ratio [ OR], 1.19; 95% confidence interval [ CI], 1.02-1.28; P = 0.041), peritoneal dissemination ( OR, 1.20; 95% CI, 1.01-1.26; P = 0.038), and under-expansion of the SEMS on the procedure day ( OR, 1.55; 95% CI, 1.26-1.62; P < 0.001) were independent predictive factors for poor improvement on the GOO scoring system, according to multivariate analysis. Conclusions SEMS under-expansion was a stent related, while poor performance status and peritoneal dissemination were patient related, predictive factors for poor oral intake after SEMS placement for malignant GOO. [ABSTRACT FROM AUTHOR]
- Published
- 2015
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