A New Self-Expandable Metallic Stent with Low Axial Force and a High Axial Force Zero-Border Shows a Very Low Perforation Rate in Malignant Colorectal Obstruction: A Japanese Multicenter Prospective Study

被引:2
作者
Murakami, Takashi [1 ]
Isayama, Hiroyuki [1 ]
Ikeda, Satoshi [2 ]
Hanabata, Norihiro [3 ]
Enomoto, Toshiyuki [4 ]
Kuwai, Toshio [5 ,6 ,7 ]
Ushigome, Mitsunori [8 ]
Ebi, Masahide [9 ]
Ohtsuka, Hideo [10 ]
Endo, Shungo [11 ]
Saito, Shuji [11 ]
Ohki, Takeshi [12 ]
Yamamoto, Ryuichi [13 ]
Kayahara, Takahisa [14 ]
Matsumoto, Satoshi [15 ]
Sasaki, Yoshihiro [16 ]
Saida, Yoshihisa [4 ]
机构
[1] Juntendo Univ, Grad Sch Med, Dept Gastroenterol, Tokyo 1138421, Japan
[2] Hiroshima Prefectural Hosp, Dept Gastroenterol Surg, Hiroshima 7348530, Japan
[3] Aomori Prefectural Cent Hosp, Dept Gastroenterol, Aomori 0300913, Japan
[4] Toho Univ, Dept Surg, Ohashi Med Ctr, Tokyo 1538515, Japan
[5] Hiroshima Univ Hosp, Gastrointestinal Endoscopy & Med, Hiroshima 7340037, Japan
[6] NHO Kure Med Ctr, Dept Gastroenterol, Hiroshima 7370023, Japan
[7] Chugoku Canc Ctr, Hiroshima 7370023, Japan
[8] Toho Univ, Dept Gen & Gastroenterol Surg, Omori Med Ctr, Tokyo 1438541, Japan
[9] Aichi Med Univ, Sch Med, Dept Gastroenterol, Nagakute 4801155, Japan
[10] Tokyo Metropolitan Tama Med Ctr, Dept Surg, Tokyo 1898511, Japan
[11] Fukushima Med Univ, Aizu Med Ctr, Dept Coloproctol, Fukushima 9693482, Japan
[12] Tokyo Womens Med Univ, Inst Gastroenterol, Dept Surg, Tokyo 1628666, Japan
[13] Tokyo West Tokushukai Hosp, Dept Gastroenterol, Tokyo 1960003, Japan
[14] Kurashiki Cent Hosp, Dept Gastroenterol & Hepatol, Okayama 7100052, Japan
[15] Chibahokusoh Hosp, Dept Gastroenterol Surg, Nippon Med Sch, Chiba 2701694, Japan
[16] Natl Hosp Org Disaster Med Ctr, Dept Gastroenterol, Tokyo 1900014, Japan
关键词
malignant colorectal obstruction; self-expandable metallic stent; JENTLLY; axial force; axial force zero-border; PLACEMENT; CANCER; EFFICACY; OUTCOMES; SOCIETY; SAFETY;
D O I
10.3390/jcm13175102
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Recently, there has been a significant increase in the utilization of self-expandable metallic stents (SEMSs) for treating malignant colorectal obstructions through colorectal stenting. The mechanical properties of SEMSs are usually considered to affect clinical outcomes of patients with malignant colorectal obstructions. Methods: This single-arm, prospective, multicenter study of SEMS with a lower axial force and high axial force zero-border included 200 patients with malignant colorectal obstruction. Technical and clinical success, stent patency, and adverse events associated with SEMS placement were evaluated. Results: One patient was excluded, and 199 patients were evaluated. The treatment intent was bridge-to-surgery in 129 and palliation in 70 patients. Technical and clinical success rates were 99.5% and 97.0%, respectively. The percentage of the ColoRectal Obstruction Scoring System scores of 3 or higher improved significantly from 19.2% before placement to 93.9% after placement. Clinical success was not achieved in five patients due to insufficient stent expansion in four patients and stent occlusion in one patient. Only one patient underwent emergency surgery for perforation of the proximal colon, far from where the stent was placed; the rescue procedure was not performed, despite no improvement in proximal dilatation due to insufficient stent expansion. Among the palliation cohort, 15 patients received chemotherapy, including molecular-targeted agents such as bevacizumab. There were no fatal cases related to stent placement. Conclusions: For management of malignant colorectal obstruction, this newly developed SEMS with low axial force and a high axial force zero-border showed high technical and clinical success rates, and an extremely low perforation rate (0.5%).
引用
收藏
页数:14
相关论文
共 21 条
[1]  
Adler DG, 2002, AM J GASTROENTEROL, V97, P72
[2]   Long-term outcomes of stent-related perforation in malignant colon obstruction: a systematic review and meta-analysis [J].
Balciscueta, Izaskun ;
Balciscueta, Zutoia ;
Uribe, Natalia ;
Garcia-Granero, Eduardo .
INTERNATIONAL JOURNAL OF COLORECTAL DISEASE, 2020, 35 (08) :1439-1451
[3]   Colonic perforation after stent placement for malignant colorectal obstruction - causes and contributing factors [J].
Datye, Arundhati ;
Hersh, Jeff .
MINIMALLY INVASIVE THERAPY & ALLIED TECHNOLOGIES, 2011, 20 (03) :133-140
[4]   Physical properties of endovascular stents: An experimental comparison [J].
Duda, SH ;
Wiskirchen, J ;
Tepe, G ;
Bitzer, M ;
Kaulich, TW ;
Stoeckel, D ;
Claussen, CD .
JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY, 2000, 11 (05) :645-654
[5]   Japanese Society for Cancer of the Colon and Rectum (JS']JSCCR) guidelines 2019 for the treatment of colorectal cancer [J].
Hashiguchi, Yojiro ;
Muro, Kei ;
Saito, Yutaka ;
Ito, Yoshinori ;
Ajioka, Yoichi ;
Hamaguchi, Tetsuya ;
Hasegawa, Kiyoshi ;
Hotta, Kinichi ;
Ishida, Hideyuki ;
Ishiguro, Megumi ;
Ishihara, Soichiro ;
Kanemitsu, Yukihide ;
Kinugasa, Yusuke ;
Murofushi, Keiko ;
Nakajima, Takako Eguchi ;
Oka, Shiro ;
Tanaka, Toshiaki ;
Taniguchi, Hiroya ;
Tsuji, Akihito ;
Uehara, Keisuke ;
Ueno, Hideki ;
Yamanaka, Takeharu ;
Yamazaki, Kentaro ;
Yoshida, Masahiro ;
Yoshino, Takayuki ;
Itabashi, Michio ;
Sakamaki, Kentaro ;
Sano, Keiji ;
Shimada, Yasuhiro ;
Tanaka, Shinji ;
Uetake, Hiroyuki ;
Yamaguchi, Shigeki ;
Yamaguchi, Naohiko ;
Kobayashi, Hirotoshi ;
Matsuda, Keiji ;
Kotake, Kenjiro ;
Sugihara, Kenichi .
INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY, 2020, 25 (01) :1-42
[6]   In vitro evaluation of the radial and axial force of self-expanding esophageal stents [J].
Hirdes, Meike M. C. ;
Vleggaar, Frank P. ;
de Beule, Matthieu ;
Siersema, Peter D. .
ENDOSCOPY, 2013, 45 (12) :997-1005
[7]   Measurement of radial and axial forces of biliary self-expandable metallic stents [J].
Isayama, Hiroyuki ;
Nakai, Yousuke ;
Toyokawa, Yoshihide ;
Togawa, Osamu ;
Gon, Chimyon ;
Ito, Yukiko ;
Yashima, Yoko ;
Yagioka, Hiroshi ;
Kogure, Hirofumi ;
Sasaki, Takashi ;
Arizumi, Toshihiko ;
Matsubara, Saburo ;
Yamamoto, Natsuyo ;
Sasahira, Naoki ;
Hirano, Kenji ;
Tsujino, Takeshi ;
Toda, Nobuo ;
Tada, Minoru ;
Kawabe, Takao ;
Omata, Masao .
GASTROINTESTINAL ENDOSCOPY, 2009, 70 (01) :37-44
[8]  
Japan Colonic Stent Safe Procedure Research Group, Mini Guidelines for Safe Placement of Colonic Stents: Safe Placement of Colonic Stents at a Glance
[9]   What is the necessity of endoscopist for successful endoscopic stenting in patients with malignant colorectal obstruction? [J].
Lee, Hyun Jung ;
Park, Soo Jung ;
Cheon, Jae Hee ;
Kim, Tae Il ;
Kim, Won Ho ;
Hong, Sung Pil .
INTERNATIONAL JOURNAL OF COLORECTAL DISEASE, 2015, 30 (01) :119-125
[10]   Clinical outcomes and factors related to colonic perforations in patients receiving self-expandable metal stent insertion for malignant colorectal obstruction [J].
Lee, Yoo Jin ;
Yoon, Jin Young ;
Park, Jae Jun ;
Park, Soo Jung ;
Kim, Jie-Hyun ;
Youn, Young Hoon ;
Kim, Tae Il ;
Park, Hyojin ;
Kim, Won Ho ;
Cheon, Jae Hee .
GASTROINTESTINAL ENDOSCOPY, 2018, 87 (06) :1548-+