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Endoscopia

versão On-line ISSN 2444-6483versão impressa ISSN 0188-9893

Resumo

MENDOZA-RAMIREZ, Jonatán; ANGULO-MOLINA, Diego; FARCA-BELSAGUY, Alberto  e  KEIL-RIOS, Daniel. Eficacia de las prótesis metálicas autoexpandibles en pacientes con estenosis del aparato digestivo de etiología maligna. Endoscopia [online]. 2019, vol.31, suppl.2, pp.382-388.  Epub 14-Fev-2022. ISSN 2444-6483.  https://doi.org/10.24875/end.m19000130.

Background:

Gastrointestinal stents are used to maintain or restore the digestive tract permeability. They are being used more frequently and therefore; we performed a study to evaluate the effectiveness of self-expanding metal stents (SEMS).

Objective:

To evaluate the effectiveness of SEMS in patients with malignant stenosis of the gastrointestinal tract treated at the ABC Medical Center.

Material and methods:

A descriptive, cross-sectional and retrospective study was conducted from January 2016 to March 2019. Patients treated in the hospital, with malignant stenosis histologically confirmed and SEMS were included. Clinical data, complications and survival were collected.

Results:

We analyzed 40 cases of patients who underwent 49 SEMS placement procedures. The average age was 65.1 years (SD ± 12.1), with a predominance of males (60%). Pancreatic cancer was the oncological pathology with the highest diagnosis (37.5%), followed by cancer of the esophagus and stomach with 12.5% each one. SEMS uncovered was the most used (85%). SEMS placed in esophagus and pylorus and duodenum resolved symptoms in all cases (technical and clinical success 100%). Enteral and colonic SEMS, a technical success of 66% and clinical success of 50% was achieved for each group. In biliary SEMS, the technical and clinical success was 90% and 80% respectively. Complications were: hemorrhage (1/49, 2%), dysfunction (3/49, 6%), tumor overgrowth (4/49, 8%), perforation (1/49, 2%), migration (1/49, 2%) and pancreatitis (1/49, 2%). The average survival was 60.5 (SD ± 34) days for esophageal SEMS, 111 (SD ± 63.4) days in pyloric and duodenal SEMS, 103 (SD ± 98) days in enteral SEMS, 187 (SD ± 68.5) days in cases with colonic SEMS and 151 (SD ± 177) days for SEMS located in the bile duct.

Conclusion:

The placement of PMAE were effective for palliation of symptoms in patients with stenosis of malignant etiology in esophagus, pylorus, duodenum and bile duct. The lower rate of technical and clinical success in enteral and colonic stenosis is probably related to the low frequency in the placement of self-expanding metal stents in these sites.

Palavras-chave : Self-expandable metal stents (SEMS); Malignant strictures; Effectiveness.

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