7077 Through-the-scope stent (ttss) for obstructive non-esophageal gastrointestinal tumors.

Abstract

Background: Endoscopic stenting for duodenal or colorectal obstruction is often more difficult due to the excessive looping of the deployment system inside the dilated stomach or tortuous axis in rectosigmoid colon. Throughthe-scope stent has the advantage of putting the stent via the working channel of the endoscope. We reported our results on through-the-scopestent (TTSS) in palliating obstructive non-esophageal gastrointestinal tumors. Materials and Methods: From Sept 98 to Aug 99, 10 patients (6 male: 4 female, mean age 64, range 35-88) received TTSS for relieving gastrointestinal obstruction. The procedure was performed under intravenous sedation and fluoroscopy. Enteral Wallstents (Schnieder, US Stent Division, USA) with a diameter of 20 or 22mm and 60 or 90mm length were used and delivered over a guidewire through the flexible endoscope with an operating channel of at least 3.7mm. Results: All stents were successfully deployed. The locations of the obstruction were: recto-sigmoid: in 3; descending colon: in 1; antral-pyloric in 3 and duodenum: in 3. All colonic stents relieved the bowel obstruction. Of these 4 colonic stents, one patient required second endoscopy to remove the stent because of persistent tenesmus and bleeding, and one patient received curative surgery for the tumor 2 weeks after stenting. For gastric outlet obstruction, the mean dysphagia score improved from 3.5 to 2 (p=0.02) after stenting. The mean survival and symptom free period was 7.25 weeks (range 0.5 to 16 weeks). One patient required another endoscopy to stop bleeding from tumor overgrowth. Conclusion: TTSS is safe and feasible. It offered a minimal invasive way to palliate obstruction in non-esophageal tumors.