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Sanz Segura P, Gotor Delso J, García Cámara P, Sierra Moros E, Val Pérez J, Soria Santeodoro MT, Uribarrena Amezaga R. Use of double-layered covered esophageal stents in post-surgical esophageal leaks and esophageal perforation: Our experience. GASTROENTEROLOGIA Y HEPATOLOGIA 2022; 45:198-203. [PMID: 34052404 DOI: 10.1016/j.gastrohep.2021.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 04/02/2021] [Accepted: 04/14/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The use of esophageal stents for the endoscopic management of esophageal leaks and perforations has become a usual procedure. One of its limitations is its high migration rate. To solve this incovenience, the double-layered covered esophageal stents have become an option. OBJECTIVES To analyse our daily practice according to the usage of double-layered covered esophageal metal stents (DLCEMS) (Niti S™ DOUBLE™ Esophageal Metal Stent Model) among patients diagnosed of esophageal leak or perforation. METHODS Retrospective, descriptive and unicentric study, with inclusion of patients diagnosed of esophageal leak or perforation, from November 2010 until October 2018. The main aim is to evaluate the efficacy of DLCEMS, in terms of primary success and technical success. The secondary aim is to evaluate their (the DLCEMS) safety profile. RESULTS Thirty-one patients were firstly included. Among those, 8 were excluded due to mortality not related to the procedure. Following stent placement, technical success was reached in 100% of the cases, and primary success, in 75% (n=17). Among the complications, stent migration was present in 21.7% of the patients (n=5), in whom the incident was solved by endoscopic means. CONCLUSIONS According to our findings, DLCEMS represent an alternative for esophageal leak and perforation management, with a high success rate in leak and perforation resolutions and low complication rate, in contrast to the published data. The whole number of migrations were corrected by endoscopic replacement, without the need of a new stent or surgery.
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Affiliation(s)
- Patricia Sanz Segura
- Servicio de Aparato Digestivo, Hospital Universitario Miguel Servet, Zaragoza, España.
| | - Jesús Gotor Delso
- Servicio de Aparato Digestivo, Hospital Universitario Miguel Servet, Zaragoza, España
| | - Paula García Cámara
- Servicio de Aparato Digestivo, Hospital Universitario Miguel Servet, Zaragoza, España
| | - Eva Sierra Moros
- Servicio de Aparato Digestivo, Hospital Universitario Miguel Servet, Zaragoza, España
| | - José Val Pérez
- Servicio de Aparato Digestivo, Hospital Universitario Miguel Servet, Zaragoza, España
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Takeuchi Y, Ebihara Y, Nakanishi Y, Asano T, Noji T, Kurashima Y, Murakami S, Nakamura T, Tsuchikawa T, Okamura K, Shichinohe T, Hirano S. A minimally invasive abdominal and left thoracic approach as a palliative treatment for adenocarcinoma of the esophagogastric junction with severe stenosis: A case report. Asian J Endosc Surg 2020; 13:215-218. [PMID: 31240864 DOI: 10.1111/ases.12718] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 04/30/2019] [Accepted: 05/06/2019] [Indexed: 01/03/2023]
Abstract
We report a novel technique for combined laparoscopy and thoracoscopy for far-advanced adenocarcinoma of the esophagogastric junction (AEG). A 56-year-old man presented with far-advanced AEG, and an esophagogastroduodenoscopy revealed a type 2 lesion that encircled the esophagogastric junction. CT revealed stenosis of the esophagogastric junction, suspected invasion into the left side of the diaphragm, and lymph node metastases in the abdomen. We diagnosed Siewert type II AEG (cT4aN1M0, cStage IIIA) according to the Japanese Classification of Gastric Carcinoma, version 14. Laparoscopic and thoracoscopic proximal gastrectomy and lower esophagectomy with double-tract reconstruction were performed as a palliative resection via a minimally invasive abdominal and left thoracic approach. However, localized peritoneal dissemination was detected. The patient was discharged with no postoperative morbidity. Hence, a minimally invasive abdominal and left thoracic approach provides good visualization, and it is safe for lower esophageal transection and intrathoracic anastomosis in the treatment of locally advanced AEG invading the surrounding tissues.
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Affiliation(s)
- Yuta Takeuchi
- Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Yuma Ebihara
- Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Yoshitsugu Nakanishi
- Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Toshimichi Asano
- Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Takehiro Noji
- Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Yo Kurashima
- Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Soichi Murakami
- Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Toru Nakamura
- Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Takahiro Tsuchikawa
- Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Keisuke Okamura
- Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Toshiaki Shichinohe
- Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Satoshi Hirano
- Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, Sapporo, Japan
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Kim KY, Tsauo J, Song HY, Park JH, Jun EJ, Zhou WZ, Kim MT. Evaluation of a New Esophageal Stent for the Treatment of Malignant and Benign Esophageal Strictures. Cardiovasc Intervent Radiol 2017; 40:1576-1585. [PMID: 28516274 DOI: 10.1007/s00270-017-1677-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Accepted: 04/28/2017] [Indexed: 01/15/2023]
Affiliation(s)
- Kun Yung Kim
- Departments of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olymic-ro 43-gil, Songpa-Gu, Seoul, 138-736, Republic of Korea
| | - Jiaywei Tsauo
- Departments of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olymic-ro 43-gil, Songpa-Gu, Seoul, 138-736, Republic of Korea
| | - Ho-Young Song
- Departments of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olymic-ro 43-gil, Songpa-Gu, Seoul, 138-736, Republic of Korea.
| | - Jung-Hoon Park
- Departments of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olymic-ro 43-gil, Songpa-Gu, Seoul, 138-736, Republic of Korea
- Biomedical Engineering Center, Asan Institute for Life Sciences, University of Ulsan College of Medicine, Songpa-Gu, Seoul, 138-736, Republic of Korea
| | - Eun Jung Jun
- Departments of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olymic-ro 43-gil, Songpa-Gu, Seoul, 138-736, Republic of Korea
| | - Wei-Zhong Zhou
- Departments of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olymic-ro 43-gil, Songpa-Gu, Seoul, 138-736, Republic of Korea
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Min Tae Kim
- Departments of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olymic-ro 43-gil, Songpa-Gu, Seoul, 138-736, Republic of Korea
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Rodrigues-Pinto E, Pereira P, Coelho R, Andrade P, Ribeiro A, Lopes S, Moutinho-Ribeiro P, Macedo G. Outcome and risk factors assessment for adverse events in advanced esophageal cancer patients after self-expanding metal stents placement. Dis Esophagus 2017; 30:1-6. [PMID: 27629280 DOI: 10.1111/dote.12467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Self-expanding metal stents (SEMS) are the treatment of choice for advanced esophageal cancers. Literature is scarce on risk factors predictors for adverse events after SEMS placement. Assess risk factors for adverse events after SEMS placement in advanced esophageal cancer and evaluate survival after SEMS placement. Cross-sectional study of patients with advanced esophageal cancer referred for SEMS placement, during a period of 3 years. Ninety-seven patients with advanced esophageal cancer placed SEMS. Adverse events were more common when tumors were located at the level of the distal esophagus/cardia (47% vs 23%, P = 0.011, OR 3.1), with statistical significance being kept in the multivariate analysis (OR 3.1, P = 0.018). Time until adverse events was lower in the tumors located at the level of the distal esophagus/cardia (P = 0.036). Survival was higher in patients who placed SEMS with curative intent (327 days [126-528] vs. 119 days [91-147], P = 0.002) and in patients submitted subsequently to surgery compared with those who did just chemo/radiotherapy or who did not do further treatment (563 days [378-748] vs. 154 days [133-175] vs. 46 days [20-72], P < 0.001). Subsequent treatment kept statistical significance in the multivariate analysis (HR 3.4, P < 0.001). SEMS allow palliation of dysphagia in advanced esophageal cancer and are associated with an increased out-of-hospital survival, as long as there are conditions for further treatments. Tumors located at the level of the distal esophagus/cardia are associated with a greater number of adverse events, which also occur earlier.
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Affiliation(s)
- E Rodrigues-Pinto
- Department of Gastroenterology, Centro Hospitalar São João, Porto, Portugal
| | - P Pereira
- Department of Gastroenterology, Centro Hospitalar São João, Porto, Portugal
| | - R Coelho
- Department of Gastroenterology, Centro Hospitalar São João, Porto, Portugal
| | - P Andrade
- Department of Gastroenterology, Centro Hospitalar São João, Porto, Portugal
| | - A Ribeiro
- Department of Gastroenterology, Centro Hospitalar São João, Porto, Portugal
| | - S Lopes
- Department of Gastroenterology, Centro Hospitalar São João, Porto, Portugal
| | - P Moutinho-Ribeiro
- Department of Gastroenterology, Centro Hospitalar São João, Porto, Portugal
| | - G Macedo
- Department of Gastroenterology, Centro Hospitalar São João, Porto, Portugal
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Hussain Z, Diamantopoulos A, Krokidis M, Katsanos K. Double-layered covered stent for the treatment of malignant oesophageal obstructions: Systematic review and meta-analysis. World J Gastroenterol 2016; 22:7841-7850. [PMID: 27678367 PMCID: PMC5016384 DOI: 10.3748/wjg.v22.i34.7841] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2016] [Revised: 07/02/2016] [Accepted: 08/01/2016] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate the efficacy of double-layered covered stent in the treatment of malignant oesophageal obstructions.
METHODS A systematic review and meta-analysis was performed following the PRISMA process. PubMed (Medline), EMBASE (Excerpta Medical Database), AMED (Allied and Complementary medicine Database), Scopus and online content, were searched for studies reporting on the NiTi-S polyurethane-covered double oesophageal stent for the treatment of malignant dysphagia. Weighted pooled outcomes were synthesized with a random effects model to account for clinical heterogeneity. All studies reporting the outcome of palliative management of dysphagia due to histologically confirmed malignant oesophageal obstruction using double-layered covered nitinol stent were included. The level of statistical significance was set at α = 0.05.
RESULTS Six clinical studies comprising 250 patients in total were identified. Pooled technical success of stent insertion was 97.2% (95%CI: 94.8%-98.9%; I2 = 5.8%). Pooled complication rate was 27.6% (95%CI: 20.7%-35.2%; I2 = 41.9%). Weighted improvement of dysphagia on a scale of 0-5 scoring system was -2.00 [95%CI: -2.29%-(-1.72%); I2 = 87%]. Distal stent migration was documented in 10 out of the 250 cases examined. Pooled stent migration rate was 4.7% (95%CI: 2.5%-7.7%; I2 = 0%). Finally, tumour overgrowth was reported in 34 out of the 250 cases with pooled rate of tumour overgrowth of 11.2% (95%CI: 3.7%-22.1%; I2 = 82.2%). No funnel plot asymmetry to suggest publication bias (bias = 0.39, P = 0.78). In the sensitivity analysis all results were largely similar between the fixed and random effects models.
CONCLUSION The double-layered nitinol stent provides immediate relief of malignant dysphagia with low rates of stent migration and tumour overgrowth
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Mao A. Interventional Therapy of Esophageal Cancer. Gastrointest Tumors 2016; 3:59-68. [PMID: 27904858 DOI: 10.1159/000447512] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 06/08/2016] [Indexed: 12/15/2022] Open
Abstract
Esophageal cancer (EC) is the fourth leading cause of cancer death in China. Despite a lot of advances in diagnosis and therapy, the survival rate of patients with EC is low. There is urgent need for a variety of methods and techniques to improve the survival time and alleviate the lesions of EC. Nowadays, alternative and less invasive approaches to the treatment of ECs are being identified. Here, we review several main interventional methods at different stages of EC, including endoscopic resection, stent placement, arterial infusion, photodynamic therapy, and radiofrequency ablation. This review will focus on the indications, methods, clinical outcomes, and complications of these methods, which may help guide the way forward.
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Affiliation(s)
- Aiwu Mao
- Department of Interventional Radiology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
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Shim CS, Kim JH, Bok GH. Development of Biliary and Enteral Stents by the Korean Gastrointestinal Endoscopists. Clin Endosc 2016; 49:113-23. [PMID: 26956192 PMCID: PMC4821526 DOI: 10.5946/ce.2016.039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 02/16/2016] [Indexed: 11/22/2022] Open
Abstract
Stenting in the gastrointestinal tract is a common procedure used for palliation of obstruction in the enteral and biliary tract. Today, stenting of malignant and benign strictures is performed at almost every major tertiary hospital in Korea. Moreover, Korea has become a major global supplier of cutting edge technology in the field of self-expanding metal stents. However, the history of stenting in Korea is relatively short and was far behind that of other nations such as Japan and Germany. The authors are humbled and gratified to have been able to observe the development and application of these stents in Korea, first hand. In this article, the authors review the overall history of stenting with a specific focus on the development of stenting in Korea. The development of esophageal, gastroduodenal, biliary, and colonic stents in Korea are reviewed in this article from a chronological and historical point of view, and a personal account of some of the significant moments of stent development in Korea are described.
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Affiliation(s)
- Chan Sup Shim
- Digestive Disease Center, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Jin Hong Kim
- Department of Gastroenterology, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea
| | - Gene Hyun Bok
- Department of Internal Medicine, Min Hospital, Seoul, Korea
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Shimatani M, Fukata N, Suzuki R, Miyamoto S, Kato K, Mitsuyama T, Miyoshi H, Ikeura T, Takaoka M, Okazaki K. Small bowel intervention and application of enteroscopy for altered small bowel anatomy—endoscopic advanced therapy using double balloon enteroscopy. GASTROINTESTINAL INTERVENTION 2014. [DOI: 10.1016/j.gii.2014.09.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Srinivasan N, Kozarek RA. The future of esophageal endoprosthetics including the use of biodegradable materials. TECHNIQUES IN GASTROINTESTINAL ENDOSCOPY 2014. [DOI: 10.1016/j.tgie.2014.03.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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10
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Martins BDC, Retes FA, Medrado BF, de Lima MS, Pennacchi CMPS, Kawaguti FS, Safatle-Ribeiro AV, Uemura RS, Maluf-Filho F. Endoscopic management and prevention of migrated esophageal stents. World J Gastrointest Endosc 2014. [PMID: 24567792 DOI: 10.4253/wjge.v6.i2.49.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
The use of self-expandable metallic stents has increased recently to palliate inoperable esophageal neoplasia and also in the management of benign strictures. Migration is one of the most common complications after stent placement and the endoscopist should be able to recognize and manage this situation. Several techniques for managing migrated stents have been described, as well as new techniques for preventing stent migration. Most stents have a "lasso" at the upper flange which facilitates stent repositioning or removal. An overtube, endoloop and large polypectomy snare may be useful for the retrieval of stents migrated into the stomach. External fixation of the stent with Shim's technique is efficient in preventing stent migration. Suturing the stent to the esophageal wall, new stent designs with larger flanges and double-layered stents are promising techniques to prevent stent migration but they warrant validation in a larger cohort of patients.
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Affiliation(s)
- Bruno da Costa Martins
- Bruno da Costa Martins, Felipe Alves Retes, Bruno Frederico Medrado, Marcelo Simas de Lima, Caterina Maria Pia Simione Pennacchi, Fabio Shiguehissa Kawaguti, Adriana Vaz Safatle-Ribeiro, Ricardo Sato Uemura, Fauze Maluf-Filho, Department of Gastroenterology, Endoscopy Division, Cancer Institute of the University of São Paulo, São Paulo 01246-000, Brazil
| | - Felipe Alves Retes
- Bruno da Costa Martins, Felipe Alves Retes, Bruno Frederico Medrado, Marcelo Simas de Lima, Caterina Maria Pia Simione Pennacchi, Fabio Shiguehissa Kawaguti, Adriana Vaz Safatle-Ribeiro, Ricardo Sato Uemura, Fauze Maluf-Filho, Department of Gastroenterology, Endoscopy Division, Cancer Institute of the University of São Paulo, São Paulo 01246-000, Brazil
| | - Bruno Frederico Medrado
- Bruno da Costa Martins, Felipe Alves Retes, Bruno Frederico Medrado, Marcelo Simas de Lima, Caterina Maria Pia Simione Pennacchi, Fabio Shiguehissa Kawaguti, Adriana Vaz Safatle-Ribeiro, Ricardo Sato Uemura, Fauze Maluf-Filho, Department of Gastroenterology, Endoscopy Division, Cancer Institute of the University of São Paulo, São Paulo 01246-000, Brazil
| | - Marcelo Simas de Lima
- Bruno da Costa Martins, Felipe Alves Retes, Bruno Frederico Medrado, Marcelo Simas de Lima, Caterina Maria Pia Simione Pennacchi, Fabio Shiguehissa Kawaguti, Adriana Vaz Safatle-Ribeiro, Ricardo Sato Uemura, Fauze Maluf-Filho, Department of Gastroenterology, Endoscopy Division, Cancer Institute of the University of São Paulo, São Paulo 01246-000, Brazil
| | - Caterina Maria Pia Simione Pennacchi
- Bruno da Costa Martins, Felipe Alves Retes, Bruno Frederico Medrado, Marcelo Simas de Lima, Caterina Maria Pia Simione Pennacchi, Fabio Shiguehissa Kawaguti, Adriana Vaz Safatle-Ribeiro, Ricardo Sato Uemura, Fauze Maluf-Filho, Department of Gastroenterology, Endoscopy Division, Cancer Institute of the University of São Paulo, São Paulo 01246-000, Brazil
| | - Fabio Shiguehissa Kawaguti
- Bruno da Costa Martins, Felipe Alves Retes, Bruno Frederico Medrado, Marcelo Simas de Lima, Caterina Maria Pia Simione Pennacchi, Fabio Shiguehissa Kawaguti, Adriana Vaz Safatle-Ribeiro, Ricardo Sato Uemura, Fauze Maluf-Filho, Department of Gastroenterology, Endoscopy Division, Cancer Institute of the University of São Paulo, São Paulo 01246-000, Brazil
| | - Adriana Vaz Safatle-Ribeiro
- Bruno da Costa Martins, Felipe Alves Retes, Bruno Frederico Medrado, Marcelo Simas de Lima, Caterina Maria Pia Simione Pennacchi, Fabio Shiguehissa Kawaguti, Adriana Vaz Safatle-Ribeiro, Ricardo Sato Uemura, Fauze Maluf-Filho, Department of Gastroenterology, Endoscopy Division, Cancer Institute of the University of São Paulo, São Paulo 01246-000, Brazil
| | - Ricardo Sato Uemura
- Bruno da Costa Martins, Felipe Alves Retes, Bruno Frederico Medrado, Marcelo Simas de Lima, Caterina Maria Pia Simione Pennacchi, Fabio Shiguehissa Kawaguti, Adriana Vaz Safatle-Ribeiro, Ricardo Sato Uemura, Fauze Maluf-Filho, Department of Gastroenterology, Endoscopy Division, Cancer Institute of the University of São Paulo, São Paulo 01246-000, Brazil
| | - Fauze Maluf-Filho
- Bruno da Costa Martins, Felipe Alves Retes, Bruno Frederico Medrado, Marcelo Simas de Lima, Caterina Maria Pia Simione Pennacchi, Fabio Shiguehissa Kawaguti, Adriana Vaz Safatle-Ribeiro, Ricardo Sato Uemura, Fauze Maluf-Filho, Department of Gastroenterology, Endoscopy Division, Cancer Institute of the University of São Paulo, São Paulo 01246-000, Brazil
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Popa D, Ramesh J, Peter S, Wilcox CM, Mönkemüller K. Small Bowel Stent-in-Stent Placement for Malignant Small Bowel Obstruction Using a Balloon-Assisted Overtube Technique. Clin Endosc 2014; 47:108-11. [PMID: 24570892 PMCID: PMC3928482 DOI: 10.5946/ce.2014.47.1.108] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2013] [Revised: 05/17/2013] [Accepted: 06/01/2013] [Indexed: 02/06/2023] Open
Abstract
Self-expanding metal stents are a useful therapy to palliate malignant and benign luminal gastrointestinal obstruction. Self-expanding metal stents has been widely reported for colonic, esophageal, and gastric obstruction. However, endoscopic delivery and placement to the small bowel is more challenging and difficult. This case illustrates the usefulness and technical advantages of the balloon-overtube and enteroscopy technique for the palliative treatment of neoplastic stenosis affecting the small intestine.
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Affiliation(s)
- Daniel Popa
- Division of Gastroenterology and Hepatology, Basil Hirschowitz Endoscopic Center of Excellence, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jayapal Ramesh
- Division of Gastroenterology and Hepatology, Basil Hirschowitz Endoscopic Center of Excellence, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Shajan Peter
- Division of Gastroenterology and Hepatology, Basil Hirschowitz Endoscopic Center of Excellence, University of Alabama at Birmingham, Birmingham, AL, USA
| | - C Mel Wilcox
- Division of Gastroenterology and Hepatology, Basil Hirschowitz Endoscopic Center of Excellence, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Klaus Mönkemüller
- Division of Gastroenterology and Hepatology, Basil Hirschowitz Endoscopic Center of Excellence, University of Alabama at Birmingham, Birmingham, AL, USA
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