Palliation in patients with malignant gastric outlet obstruction with a newly designed enteral stent: a multicenter study

Background: Through-the-scope (TTS) stents facilitate palliative enteral stent placement. However, most TTS stents are braided, a characteristic that has been associated with significant foreshortening and relatively frequent migration. Objectives: To evaluate clinical experience with a new woven enteral stent in the treatment of gastric outlet obstruction. Design: From January 2005 to August 2006, patients with unresectable malignant gastric outlet obstruction were offered stent placement with a new woven stent. Setting: Three referral hospitals in Japan. Patients: Thirty-seven consecutive patients with malignant gastric outlet obstruction. Interventions: A newly designed enteral stent was placed by using the TTS placement technique. Main Outcome Measurements: Palliation efficacy and safety of the new stents. Results: Stent placement was successful in 36 of 37 patients (technical success, 97%). Thirty-four patients were able to tolerate oral intake without obstructive symptoms (clinical success, 94.4%). Complications occurred in 16.2% of patients, comprising 2 cases of primary stent dysfunction, 1 perforation, 1 GI bleeding, I stent obstruction, and 1 biliary stent dysfunction. No migration was seen during the median follow-up period of 68 days. Limitations: Small sample size and relatively brief follow-up. Conclusions: A newly developed enteral stent with higher flexibility and less foreshortening offers comparable clinical outcome to existing stents and a lower frequency of complications, including migration.