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Fully covered, retrievable self-expanding metal stents (Niti-S) in palliation of malignant dysphagia: long-term results of a prospective study.

Choi, SJ; Kim, JH; Choi, JW; Lim, SG; Shin, SJ; Lee, KM; Lee, KJ
Scandinavian journal of gastroenterology, 46(7-8):875-880, 2011
Journal Title
Scandinavian journal of gastroenterology
BACKGROUND: In the palliative treatment of malignant dysphagia, fully covered, retrievable metal stents are not commonly used, mainly due to the high risk of migration. Therefore, we performed a prospective study to evaluate the clinical efficacy of a fully covered, retrievable self-expanding metal stent (Niti-S).

METHOD: Between October 1998 and February 2009, 100 consecutive patients with malignant esophageal obstruction treated with the fully covered Niti-S stent (Niti-S, Taewoong Medical, Seoul, South Korea) were included. Data collected contained functional outcome, feasibility of endoscopic stent retrieval, recurrent dysphagia, complications, and survival.

RESULT: At 4 weeks after stent placement, dysphagia significantly improved in all patients (p = 0.000). Recurrent dysphagia occurred in 19 of 100 patients treated with Niti-S stents (19%) mainly due to tumor overgrowth (7/100, 7%), stent migration (6/100, 6%), and food impaction (6/100, 6%). Endoscopic stent retrieval was successful in all the attempted 17 patients (17/100, 17%)--7 overgrowth, 6 stent migration, 2 stent degradation, and 2 severe pain. Major complications were 2 hemorrhage, 2 severe pain, and 1 tracheal compression (5/100, 5%), and minor complications were 10 retrosternal pain and 7 symptomatic gastroesophageal reflux (17/100, 17%). After a median follow-up of 142 days, 97 patients had expired. There was no stent-related mortality or 30-day mortality.

CONCLUSION: The fully covered, retrievable Niti-S stent has proved its effectiveness for palliation of malignant dysphagia and feasibility of endoscopic retrieval. We estimate its dog-bone shaped flanges at both ends and it being completely covered provide good resistance to migration and overgrowth.
MeSH terms
AgedConstriction, Pathologic/etiology/therapyDevice RemovalEsophageal Neoplasms/*complicationsEsophagus/pathologyFemaleHumansKaplan-Meier EstimateLung Neoplasms/*complicationsMaleMiddle Aged*Palliative CareProspective StudiesProsthesis FailureRecurrenceStents/*adverse effectsStomach Neoplasms/*complications
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Journal Papers > School of Medicine / Graduate School of Medicine > Gastroenterology
AJOU Authors
김, 진홍임, 선교신, 성재이, 기명이, 광재
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