Clinical Endoscopy

Review

Endoscopic stenting for malignant gastric outlet obstruction: focusing on comparison of endoscopic stenting and surgical gastrojejunostomy: Sun Gyo Lim, Chan Gyoo Kim; Clin Endosc 2024;57(5):571-580. Published online February 23, 2024; DOI: https://doi.org/10.5946/ce.2023.160

Malignant gastric outlet obstruction (GOO) is a condition characterized by blockage or narrowing where the stomach empties its contents into the small intestine due to primary malignant tumors or metastatic diseases. This condition leads to various symptoms such as nausea, vomiting, abdominal pain, and weight loss. To manage malignant GOO, different treatment options have been employed, including surgical gastrojejunostomy (SGJ), gastroduodenal stenting (GDS) using self-expandable metallic stent (SEMS), and endoscopic ultrasound-guided gastrojejunostomy (EUS-GJ). This review focuses on comparing the clinical outcomes of endoscopic stenting (GDS and EUS-GJ) with SGJ for malignant GOO. Studies have shown that GDS with SEMS provides comparable clinical outcomes and safety for the palliation of obstructive symptoms. The choice between covered and uncovered SEMS remains controversial, as different studies have reported varying results. EUS-GJ, performed via endoscopic ultrasound guidance, has shown promising efficacy and safety in managing malignant GOO, but further studies are needed to establish it as the primary treatment option. Comparative analyses suggest that GDS has higher recurrence and reintervention rates compared to EUS-GJ and SGJ, with similar overall procedural complications. However, bleeding rates were lower with GDS than with SGJ. Randomized controlled trials are required to determine the optimal treatment approach for malignant GOO.

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Palliative management for malignant biliary obstruction and gastric outlet obstruction from pancreatic cancer
Pengfei Wu, Kai Chen, Jin He
Annals of Gastroenterological Surgery.2024;[Epub] CrossRef

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Original Article

Self-expandable metallic stent-induced esophagorespiratory fistulas in patients with advanced esophageal cancer: Iatagan R. Josino, Bruno C. Martins, Andressa A. Machado, Gustavo R. de A. Lima, Martin A. C. Cordero, Amanda A. M. Pombo, Rubens A. A. Sallum, Ulysses Ribeiro Jr, Todd H. Baron, Fauze Maluf-Filho; Clin Endosc 2023;56(6):761-768. Published online July 25, 2023; DOI: https://doi.org/10.5946/ce.2022.297

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Background
/Aims: Self-expandable metallic stents (SEMSs) are widely adopted for the palliation of dysphagia in patients with malignant esophageal strictures. An important adverse event is the development of SEMS-induced esophagorespiratory fistulas (SEMS-ERFs). This study aimed to assess the risk factors related to the development of SEMS-ERF after SEMS placement in patients with esophageal cancer.
Methods
This retrospective study was performed at the Instituto do Cancer do Estado de São Paulo. All patients with malignant esophageal strictures who underwent esophageal SEMS placement between 2009 and 2019 were included in the study.
Results
Of the 335 patients, 37 (11.0%) developed SEMS-ERF, with a median time of 129 days after SEMS placement. Stent flare of 28 mm (hazard ratio [HR], 2.05; 95% confidence interval [CI], 1.15–5.51; p=0.02) and post-stent chemotherapy (HR, 2.0; 95% CI, 1.01–4.00; p=0.05) were associated with an increased risk of developing SEMS-ERF, while lower-third tumors were a protective factor (HR, 0.5; 95% CI, 0.26–0.85; p=0.01). No difference was observed in overall survival.
Conclusions
The incidence of SEMS-ERFs was 11%, with a median time of 129 days after SEMS placement. Post-stent chemotherapy and a 28 mm stent flare were associated with a higher risk of SEMS-ERF.

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Clinical Implications of Circulating Tumor Cells in Patients with Esophageal Squamous Cell Carcinoma: Cancer-Draining Blood Versus Peripheral Blood
Dong Chan Joo, Gwang Ha Kim, Hoseok I, Su Jin Park, Moon Won Lee, Bong Eun Lee
Cancers.2024; 16(16): 2921. CrossRef
How to reduce fistula formation after self-expandable metallic stent insertion for treating malignant esophageal stricture?
Kwang Bum Cho
Clinical Endoscopy.2023; 56(6): 735. CrossRef

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Review

Optimal endoscopic drainage strategy for unresectable malignant hilar biliary obstruction: Itaru Naitoh, Tadahisa Inoue; Clin Endosc 2023;56(2):135-142. Published online January 5, 2023; DOI: https://doi.org/10.5946/ce.2022.150

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Endoscopic biliary drainage strategies for managing unresectable malignant hilar biliary obstruction differ in terms of stent type, drainage area, and deployment method. However, the optimal endoscopic drainage strategy remains unclear. Uncovered self-expandable metal stents (SEMS) are the preferred type because of their higher functional success rate, longer time to recurrent biliary obstruction (RBO), and fewer cases of reintervention than plastic stents (PS). Other PS subtypes and covered SEMS, which feature a longer time to RBO than PS, can be removed during reintervention for RBO. Bilateral SEMS placement is associated with a longer time to RBO and a longer survival time than unilateral SEMS placement. Unilateral drainage is acceptable if a drainage volume of greater than 50% of the total liver volume can be achieved. In terms of deployment method, no differences were observed in clinical outcomes between side-by-side (SBS) and stent-in-stent deployment. Simultaneous SBS boasts a shorter procedure time and higher technical success rate than sequential SBS. This review of previous studies aimed to clarify the optimal endoscopic biliary drainage strategy for unresectable malignant hilar biliary obstruction.

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Comparison of unilateral and bilateral intraductal plastic stent placement for unresectable malignant hilar biliary obstruction: A propensity score‐matched cohort analysis
Mitsuru Okuno, Keisuke Iwata, Tsuyoshi Mukai, Yuhei Iwasa, Shinya Uemura, Kensaku Yoshida, Akinori Maruta, Takuji Iwashita, Ichiro Yasuda, Masahito Shimizu
Journal of Hepato-Biliary-Pancreatic Sciences.2024; 31(4): 284. CrossRef
Preoperative endoscopic biliary drainage by metal versus plastic stents for resectable perihilar cholangiocarcinoma
David M. de Jong, Timothy M. Gilbert, Lynn E. Nooijen, Eva Braunwarth, Marijana Ninkovic, Florian Primavesi, Hassan Z. Malik, Nick Stern, Richard Sturgess, Joris I. Erdmann, Rogier P. Voermans, Marco J. Bruno, Bas Groot Koerkamp, Lydi M.J.W. van Driel
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TOKYO criteria 2024 for the assessment of clinical outcomes of endoscopic biliary drainage
Hiroyuki Isayama, Tsuyoshi Hamada, Toshio Fujisawa, Mitsuharu Fukasawa, Kazuo Hara, Atsushi Irisawa, Shigeto Ishii, Ken Ito, Takao Itoi, Yoshihide Kanno, Akio Katanuma, Hironari Kato, Hiroshi Kawakami, Hirofumi Kawamoto, Masayuki Kitano, Hirofumi Kogure,
Digestive Endoscopy.2024; 36(11): 1195. CrossRef
Trisectoral Metal Stenting Using Combined Stent-by-Stent and Stent-in-Stent Method for Malignant Hilar Biliary Obstruction: A Prospective Pilot Study
Tadahisa Inoue, Rena Kitano, Mayu Ibusuki, Tomoya Kitada, Kazumasa Sakamoto, Satoshi Kimoto, Jun Arai, Kiyoaki Ito
Digestive Diseases and Sciences.2024; 69(11): 4283. CrossRef
Suprapapillary trisectoral deployment of slim fully covered metal stents with ultra-stiff high-sliding guidewires for malignant hilar biliary obstruction
Tadahisa Inoue, Rena Kitano, Tomoya Kitada, Kazumasa Sakamoto, Satoshi Kimoto, Jun Arai, Kiyoaki Ito
Endoscopy.2024; 56(S 01): E996. CrossRef
Efficacy and safety of covered self-expandable metal stents for malignant hilar biliary obstruction: systematic review and meta-analysis
Kwang Hyun Chung, Kyong Joo Lee, Abel A. Joseph, Robert J. Huang, Andrew Li, Joo Ha Hwang, Seung Bae Yoon
Gastrointestinal Endoscopy.2024;[Epub] CrossRef
Evaluating safety and efficacy of plastic versus metal stenting in malignant hilar biliary obstruction: a systematic review and meta-analysis of randomized controlled trials
Xinjie Luo, Zhicheng Huang, Kamran Ali, Khizar Hayat
Postgraduate Medical Journal.2024;[Epub] CrossRef
Research progress on biliary stents
Qi Zhang, Haipo Cui, Yan Zhang, Hexuan Jiang
Progress in Medical Devices.2023;[Epub] CrossRef

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Original Articles

Laser-cut-type versus braided-type covered self-expandable metallic stents for distal biliary obstruction caused by pancreatic carcinoma: a retrospective comparative cohort study: Koh Kitagawa, Akira Mitoro, Takahiro Ozutsumi, Masanori Furukawa, Yukihisa Fujinaga, Kenichiro Seki, Norihisa Nishimura, Yasuhiko Sawada, Kosuke Kaji, Hideto Kawaratani, Hiroaki Takaya, Kei Moriya, Tadashi Namisaki, Takemi Akahane, Hitoshi Yoshiji; Clin Endosc 2022;55(3):434-442. Published online October 28, 2021; DOI: https://doi.org/10.5946/ce.2021.161

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Background
/Aims: Covered self-expandable metallic stents (CMSs) are widely used for malignant distal biliary obstructions (MDBOs) caused by pancreatic carcinoma. This study compared the efficacy and safety of the laser-cut-type and braided-type CMSs.
Methods
To palliate MDBOs caused by pancreatic carcinoma, the laser-cut-type CMSs was used from April 2014 to March 2017, and the braided-type CMSs was used from April 2017 to March 2019. The tested self-expandable metallic stents were equipped with different anti-migration systems.
Results
In total, 47 patients received CMSs for MDBOs (24 laser-cut type, 23 braided-type). The time to recurrent biliary obstruction (TRBO) was significantly longer in the braided-type CMSs (p=0.0008), and the median time to stent dysfunction or patient death was 141 and 265 days in the laser-cut-type CMSs and braided-type CMSs, respectively (p=0.0023). Stent migration was the major cause of stent dysfunction in both groups, which occurred in 37.5% of the laser-cut-type CMSs and 13.0% of the braidedtype CMSs. There were no differences in the survival duration between the groups.
Conclusions
The TRBO was significantly longer for the braided-type CMSs with an anti-migration system than for the laser-cuttype. Stent migration tended to be less frequent with the braided-type CMSs than with the laser-cut-type CMSs.

Citations

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Braided-type stent versus laser-cut-type stent for patients with unresectable distal malignant biliary obstruction: a randomized controlled trial
Sho Hasegawa, Takamitsu Sato, Satoru Shinoda, Yusuke Kurita, Tomoki Ogata, Shinichi Nihei, Shin Yagi, Kunihiro Hosono, Itaru Endo, Noritoshi Kobayashi, Kensuke Kubota, Atsushi Nakajima
Gastrointestinal Endoscopy.2024; 99(5): 739. CrossRef
Removal of Duckbill‐type laser‐cut anti‐reflux metal stents: Clinical evaluation and in vitro study
Yuto Yamada, Takashi Sasaki, Tsuyoshi Takeda, Takeshi Okamoto, Takafumi Mie, Chinatsu Yonekura, Takaaki Furukawa, Akiyoshi Kasuga, Masato Matsuyama, Masato Ozaka, Takahisa Matsuda, Yoshinori Igarashi, Naoki Sasahira
DEN Open.2023;[Epub] CrossRef
Comparable Efficacy of Laser-Cut and Braided Self Expanding Metallic Biliary Stent: A Systematic Review and Meta-Analysis
Priyadarshini Loganathan, Saurabh Chandan, Babu P. Mohan, Shreyas Saligram, Douglas G. Adler
Digestive Diseases and Sciences.2023; 68(9): 3756. CrossRef
Evaluation of the mechanical properties of current biliary self-expandable metallic stents: axial and radial force, and axial force zero border
Wataru Yamagata, Toshio Fujisawa, Takashi Sasaki, Rei Ishibashi, Tomotaka Saito, Shuntaro Yoshida, Shizuka No, Kouta Inoue, Yousuke Nakai, Naoki Sasahira, Hiroyuki Isayama
Clinical Endoscopy.2023; 56(5): 633. CrossRef
Covered self-expandable metal stents for distal biliary obstruction from pancreatic carcinoma: what type of stent is preferred?
Hideyuki Shiomi, Ryota Nakano, Shogo Ota
Clinical Endoscopy.2022; 55(3): 369. CrossRef

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Cholecystitis after Placement of Covered Self-Expandable Metallic Stents in Patients with Distal Malignant Biliary Obstructions: Masafumi Watanabe, Kosuke Okuwaki, Jun Woo, Mitsuhiro Kida, Hiroshi Imaizumi, Tomohisa Iwai, Hiroshi Yamauchi, Toru Kaneko, Rikiya Hasegawa, Takahiro Kurosu, Naoki Minato, Hiroki Haradome, Wasaburo Koizumi; Clin Endosc 2021;54(4):589-595. Published online November 17, 2020; DOI: https://doi.org/10.5946/ce.2020.136

Abstract PDF PubReader ePub

Background
/Aims: Cholecystitis can occur after the placement of covered self-expandable metallic stents for distal malignant biliary obstructions. We aimed to identify risk factors for cholecystitis following covered self-expandable metallic stent placement.
Methods
We investigated risk factors related to cholecystitis following covered self-expandable metallic stent placement in 118 patients with distal malignant biliary obstructions between January 1, 2015 and April 30, 2019. Endoscopic assessments and tumor invasion to the arteries feeding the gallbladder were determined by a pancreaticobiliary endoscopist and a radiologist, respectively.
Results
The median patient age was 72 years (men, 61.0%). The flow of the contrast agent into the gallbladder and tumor involvement in the orifice of the cystic duct were observed in 35 (29.7%) and 35 (29.7%) patients, respectively. During the observation period (median, 179 days), cholecystitis occurred in 18 (15.3%) patients. Multivariate analysis revealed the flow of the contrast agent into the gallbladder (p=0.023) and tumor involvement in the orifice of the cystic duct (p=0.005) as significant independent risk factors associated with cholecystitis.
Conclusions
The flow of the contrast agent into the gallbladder and tumor involvement in the orifice of the cystic duct are potential independent risk factors for cholecystitis following the placement of covered self-expandable metallic stents. A follow-up prospective study is warranted to validate their influence.

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Adverse events of self-expandable metal stent placement for malignant distal biliary obstruction: a large multicenter study
Takashi Tamura, Takuo Yamai, Norimitsu Uza, Tomoaki Yamasaki, Atsuhiro Masuda, Fumimasa Tomooka, Hirotsugu Maruyama, Minoru Shigekawa, Takeshi Ogura, Katsutoshi Kuriyama, Masanori Asada, Hisakazu Matsumoto, Mamoru Takenaka, Koichiro Mandai, Yui Osaki, Ken
Gastrointestinal Endoscopy.2024; 99(1): 61. CrossRef
Fully covered versus partially covered self-expandable metal stents for palliation of distal malignant biliary obstruction: a systematic review and meta-analysis
Giuseppe Vanella, Chiara Coluccio, Alessandro Cucchetti, Roberto Leone, Giuseppe Dell’Anna, Paolo Giuffrida, Carmela Abbatiello, Cecilia Binda, Carlo Fabbri, Paolo Giorgio Arcidiacono
Gastrointestinal Endoscopy.2024; 99(3): 314. CrossRef
Endoscopic Ultrasound–Guided vs Endoscopic Retrograde Cholangiopancreatography–Guided Biliary Drainage as Primary Approach to Malignant Distal Biliary Obstruction: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Harishankar Gopakumar, Ritu Raj Singh, Vakya Revanur, Rajanikanth Kandula, Srinivas R. Puli
American Journal of Gastroenterology.2024; 119(8): 1607. CrossRef
Cholecystitis in patients with a fully covered self-expandable metal stent with and without externally anchored plastic stents
José Miguel Jiménez-Gutiérrez, Félix Téllez-Avila
Endoscopy.2024; 56(04): 317. CrossRef
Risk factors and treatment strategies for cholecystitis after metallic stent placement for malignant biliary obstruction: a multicenter retrospective study
Akihiro Matsumi, Hironari Kato, Taiji Ogawa, Toru Ueki, Masaki Wato, Masakuni Fujii, Tatsuya Toyokawa, Ryo Harada, Yuki Ishihara, Masahiro Takatani, Hirofumi Tsugeno, Naoko Yunoki, Takeshi Tomoda, Toshiharu Mitsuhashi, Motoyuki Otsuka
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Mena Louis, Nathaniel Grabill, Baraa Mohamed, Firdous Khan, Joe Williams, Nelson A Royall
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Naoki Minato, Kosuke Okuwaki, Masafumi Watanabe, Jun Woo, Takaaki Matsumoto, Masayoshi Tadehara, Toru Kaneko, Junro Ishizaki, Tomohisa Iwai, Hiroshi Imaizumi, Mitsuhiro Kida, Hiroki Haradome, Chika Kusano
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Se Woo Park, Kyong Joo Lee, Moon Jae Chung, Jung Hyun Jo, Hee Seung Lee, Jeong Youp Park, Seung Woo Park, Si Young Song, Huapyong Kang, Eui Joo Kim, Yeon Suk Kim, Jae Hee Cho, Seungmin Bang
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Risk factors for early and late cholecystitis after covered metal stent placement for distal biliary obstruction
Tatsuya Ishii, Tsuyoshi Hayashi, Hajime Yamazaki, Risa Nakamura, Kosuke Iwano, Ryo Ando, Haruka Toyonaga, Toshifumi Kin, Kuniyuki Takahashi, Akio Katanuma
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Efficacy and complications of inoperable malignant distal biliary obstruction treatment by metallic stents: fully covered or uncovered?
Jiangning Gu, Xiaoyi Guo, Yong Sun, Bin Fan, Haoran Li, Ting Luo, Haifeng Luo, Jiao Liu, Feng Gao, Yuan Gao, Guang Tan, Xiaoming Liu, Zhuo Yang
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Dong Wook Lee, Eun Young Kim
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Case Report

A remnant choledochal cyst after choledochal cyst excision treated with a lumen-apposing metal stent: a case report: Bo Kyung Kim, Jung Won Chun, Sang Hyub Lee, Ji Kon Ryu, Yong-Tae Kim, Woo Hyun Paik; Clin Endosc 2022;55(4):564-569. Published online January 8, 2020; DOI: https://doi.org/10.5946/ce.2019.176

Abstract PDF PubReader ePub

A lumen-apposing metal stent (LAMS) is a saddle-shaped stent with large flanges at both ends, thereby preventing stent migration and helping with approximation of the adjacent structures. We report the case of a 25-year-old female with remnant choledochal cyst which was successfully treated with LAMS after initial treatment failure with a plastic stent. Although complete excision of the cyst is the definite treatment of choledochal cysts, endoscopic ultrasonography-guided cystoduodenostomy can be considered in cases wherein surgery is not feasible and dysplasia is not present. LAMS may be preferred to plastic stents for effective resolution of remnant choledochal cyst and prevention of ascending infection.

Citations

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Hepatic multiple hyperintense cystic lesions: a rare caroli disease
Mohammed H. Alsharif, Nagi M. Bakhit, Abdulaziz Alarifi, Elbagir M. Nassir, Abair A. Mahdi, Juman M. Almasaad, Abubaker Y. Elamin, Khalid M. Taha
THE NEW ARMENIAN MEDICAL JOURNAL.2023; (1, 17 (202): 41. CrossRef
Hepatic multiple hyperintense cystic lesions: a rare caroli disease.
Mohammed H. Alsharif, Nagi.M Bakhit, Abdulaziz Alarifi, Elbagir M. Nassir, Abair A. Mahdi, Juman M. Almasaad, Abubaker.Y. Elamin, Khalid M. Taha
THE NEW ARMENIAN MEDICAL JOURNAL.2023; (1, 17 (202): 41. CrossRef

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Original Articles

Efficacy and Safety of Lumen-Apposing Stents for Management of Pancreatic Fluid Collections in a Community Hospital Setting: Rajat Garg, Abdelkader Chaar, Susan Szpunar, Babu P. Mohan, Mohammed Barawi; Clin Endosc 2020;53(4):480-486. Published online October 16, 2019; DOI: https://doi.org/10.5946/ce.2019.116

Abstract PDF PubReader ePub

Background
/Aims: Endoscopic ultrasound-guided transmural drainage and necrosectomy employing lumen-apposing metal stent (LAMS) are used for treating pancreatic fluid collections (PFCs) with excellent results from academic centers. Herein, we report the efficacy and safety of LAMS in the treatment of PFCs at a community hospital.
Methods
We retrospectively reviewed the etiology of pancreatitis, type and size of PFCs, length of procedure, technical success, clinical success, adverse events, and stent removal. The primary outcome was the rate of clinical success, and secondary outcomes were technical success and adverse events.
Results
Twenty-seven patients with a mean age of 54.1±6.5 years were included, 44% of which were men. The mean size of the PFCs was 9.7±5.0 cm (range, 3–21). The most common etiology of pancreatitis was alcohol (44%) followed by idiopathic causes (30%) and presence of gallstones (22%). The diagnosis was pseudocyst in 44.4% (12/27) and walled off necrosis in 55.6% (15/27) of patients. There was 100% technical success without any complications. Clinical success was achieved in 22 of 27 patients (81.5%) who underwent stent removal.
Conclusions
Our study is the first to report that endoscopic therapy of PFCs using LAMS is safe and effective even in a community hospital setting with limited resources and support compared to large academic centers.

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EUS-guided interventional therapies for pancreatic diseases
Rongmin Xu, Kai Zhang, Nan Ge, Siyu Sun
Frontiers in Medicine.2024;[Epub] CrossRef
Trans-cavity lumen-apposing metal stent removal: an alternative safe modality
Giacomo Emanuele Maria Rizzo, Ilaria Tarantino
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Elia Armellini, Flavio Metelli, Andrea Anderloni, Anna Cominardi, Giovanni Aragona, Michele Marini, Fabio Pace
World Journal of Gastroenterology.2023; 29(21): 3341. CrossRef
Lumen-apposing metal stents
Carlo Fabbri, Chiara Coluccio, Cecilia Binda, Alessandro Fugazza, Andrea Anderloni, Ilaria Tarantino
Endoscopic Ultrasound.2022; 11(1): 59. CrossRef
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Hussam I. A. Alzeerelhouseini, Muawiyah Elqadi, Mohammad N. Elqadi, Sadi A. Abukhalaf, Hazem A. Ashhab, Yoshifumi Nakayama
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Jing Li, Qian Zhang, Anni Zhou, Guiping Zhao, Peng Li
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Reply
Kazuki Takeishi, Toru Ikegami, Tomoharu Yoshizumi, Nao Fujimori, Masaki Mori
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Safety and efficacy of lumen-apposing metal stents versus plastic stents to treat walled-off pancreatic necrosis: systematic review and meta-analysis
Vinay Chandrasekhara, Marc Barthet, Jacques Devière, Fateh Bazerbachi, Sundeep Lakhtakia, Jeffrey J. Easler, Joyce A. Peetermans, Edmund McMullen, Ornela Gjata, Margaret L. Gourlay, Barham K. Abu Dayyeh
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Comparison of Clinical Outcomes between Plastic Stent and Novel Lumen-apposing Metal Stent for Endoscopic Ultrasound-Guided Drainage of Peripancreatic Fluid Collections: Ho Cheol Shin, Chang Min Cho, Min Kyu Jung, Seong Jae Yeo; Clin Endosc 2019;52(4):353-359. Published online March 13, 2019; DOI: https://doi.org/10.5946/ce.2018.154

Abstract PDF PubReader ePub

Background
/Aims: Endoscopic ultrasound (EUS)-guided transmural drainage for peripancreatic fluid collections (PFCs) has gained wide acceptance as a nonsurgical intervention. Although a lumen-apposing metal stent (LAMS) was recently introduced, there are few data comparing the clinical outcomes between LAMS and plastic stent (PS) drainage.
Methods
Endoscopy databases of all patients who had undergone EUS-guided drainage for PFCs were searched and the clinical outcomes of EUS-guided drainage according to stent-type used were compared.
Results
A total of 27 patients (median age, 56 years) with PFCs underwent EUS-guided transmural drainage between January 2011 and December 2017. Of these, 17 underwent PS placement and 10 underwent LAMS placement. There was no significant difference in the technical success rate between the 2 groups (94.1% vs. 100%, p=1.0). Procedure time was shorter in the LAMS group compared to that in the PS group (10.6±2.5 min vs. 21.4±9.5 min, p=0.002). Among subjects with clinical success, recurrence of PFC after stent removal occurred in 5 of 12 patients with PS and 4 of 10 with LAMS, without statistical difference (41.7% vs. 40.0%, p=1.0).
Conclusions
Although our study showed similar clinical outcomes for LAMS and PS, further prospective trials are required to validate the superiority of LAMS.

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Fadi Hawa, Jean M. Chalhoub, Ana Vilela, Elit Quingalahua, Carol Shannon, George M. Philips, Richard S. Kwon, Erik-Jan Wamsteker, Allison R. Schulman, Matthew J. DiMagno, Jorge D. Machicado
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Anupam Kumar Singh, Manish Manrai, Rakesh Kochhar
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Review

Evidence-Based Recommendations on Colorectal Stenting: A Report from the Stent Study Group of the Korean Society of Gastrointestinal Endoscopy: Kwang Jae Lee, Sang Woo Kim, Tae Il Kim, Jong-Hoon Lee, Bo-In Lee, Bora Keum, Dae Young Cheung, Chang Heon Yang, The Stent Study Group of the Korean Society of Gastrointestinal Endoscopy; Clin Endosc 2013;46(4):355-367. Published online July 31, 2013; DOI: https://doi.org/10.5946/ce.2013.46.4.355

Abstract PDF PubReader ePub

Recently, placement of self-expandable metallic stents has been used for the treatment of colorectal obstruction. As domestic awareness of colorectal cancer has increased, the number of colorectal stenting procedures performed has also increased. We aimed to provide evidence-based recommendations for colorectal stenting to aid gastroenterologists in making informed decisions regarding the management of patients who present with colorectal obstruction. The working group consisted of eight gastroenterologists who actively practice and conduct research in the field of colorectal stenting and are the members of the Stent Study Group of the Korean Society of Gastrointestinal Endoscopy. A literature search was conducted using the PubMed, Embase, KoreaMed, and the Cochrane Library databases to identify relevant articles published between January 2001 and June 2012. Based on the modified Delphi process, 10 recommendation statements regarding indications, usefulness, methodology and complications of colorectal stenting, and alternative treatments for malignant colorectal obstruction were determined. The contents will be widely distributed, and periodically revised to reflect the latest knowledge. These evidence-based recommendations for colorectal stenting will provide gastroenterologists and patients with appropriate and balanced information, and will improve the quality of care.

Citations

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