Korean J Gastroenterol.  2007 Jan;49(1):4-9.

The Usefulness of Clip Application in Preventing Migration of Self-expandable Metal Stent in Patients with Malignant Gastrointestinal Obstruction

• Park SY
• Park CH
• Cho SB
• Lee JS
• Joo SY
• Park HC
• Lee WS
• Joo YE
• Kim HS
• Choi SK
• Rew JS
• Kim SJ

Abstract

BACKGROUND/AIMS: Management of malignant gastrointestinal obstruction presents a significant challenge. Recently, self-expandable metal stent (SEMS) has emerged as an effective, safe, and less invasive alternative for the treatment of malignant intestinal obstruction. Accordingly, we reviewed our experience in SEMS insertion with hemoclip placement. METHODS: Between June 2004 and December 2005, a total of 40 SEMS were tried to place in 38 patients with malignant intestinal obstruction. Two stents were placed again due to recurrent obstruction and delayed stent migration after initial stent placement. We analyzed the technical and clinical success rates and complications. RESULTS: Total stent placement was successful in 38/40 (95%). In 2 cases, stent placement was failed due to complete obstruction. Twenty-eight stents for palliation of malignant intestinal stenosis, 9 stents for one-staged operation for malignant colonic obstruction, and 1 stent for management of tracheoesophageal fistula were placed. Stent migration occurred in 6/38 (15.8%). Early stent migration rate was significantly lower in the clipping group (0/19, 0%) than in the non-clipping group (5/19, 26.3%, p=0.04). Recurrent obstruction occurred in 2/38 (6.1%) due to tumor ingrowth and in 1/38 (2.6%) due to hard food materials. CONCLUSIONS: Application of the clips reduce early stent migration in patients with malignant gastrointestinal obstruction.

Keyword

Malignant gastrointestinal obstruction; Self-expandable metal stents; Clip application

MeSH Terms

Adult
Aged
Aged, 80 and over
Colonic Neoplasms/surgery
Digestive System Surgical Procedures/instrumentation
Esophageal Neoplasms/surgery
Female
Gastrointestinal Neoplasms/*surgery
Humans
Intestinal Obstruction/*surgery
Male
Middle Aged
Prostheses and Implants
Retrospective Studies
*Stents
Stomach Neoplasms/surgery