Gut and Liver (Jan 2017)

Factors That Affect Stent-Related Complications in Patients with Malignant Obstruction of the Esophagus or Gastric Cardia

  • Hiroyasu Iwasaki,
  • Takashi Mizushima,
  • Yuta Suzuki,
  • Shigeki Fukusada,
  • Kenta Kachi,
  • Takanori Ozeki,
  • Kaiki Anbe,
  • Hironobu Tsukamoto,
  • Fumihiro Okumura,
  • Takashi Joh,
  • Hitoshi Sano

DOI
https://doi.org/10.5009/gnl16172
Journal volume & issue
Vol. 11, no. 1
pp. 47 – 54

Abstract

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Background/AimsSelf-expandable metallic stent (SEMS) placement is effective for dysphagia that results from malignant obstruction of the esophagus or gastric cardia; however, stent-related complications may be life-threatening. Thus, the goal of this study was to identify risk factors associated with complications following esophageal stenting.Methods : Of the 71 patients who underwent SEMS placement for dysphagia as a result of malignant stricture of the esophagus or gastric cardia, 53 patients with squamous cell carcinoma or adenocarcinoma, without previous SEMS placement, without a fistula, and without recurrent tumor after surgery were retrospectively identified. The occurrence of stent-related complications was used as an endpoint.Results : Stent-related complications were identified in 26 patients (49.1%), and major complications occurred in 14 patients (26.4%). The use of an Ultraflex stent (odds ratio [OR], 6.81; 95% confidence interval [CI], 1.54 to 30.00; p=0.011) and prior chemotherapy (OR, 6.13; 95% CI, 1.46 to 25.70; p=0.013) were significantly associated with stent-related complications. Moreover, the use of an Ultraflex stent (OR, 19.60; 95% CI, 2.26 to 170.00; p=0.007) and prior radiation (OR, 25.70; 95% CI, 2.37 to 280.00; p=0.008) significantly increased the risk of major complications.Conclusion : sThe use of an Ultraflex stent and prior radiation and/or chemotherapy may represent risk factors for complications following esophageal SEMS placement.

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