Preliminary results of the use of self-expanding nitinol stents in inoperable gastrointestinal cancers

*Tomasz Miłek¹, Piotr Ciostek¹, Witold Wożniak¹, Andrzej Lewczuk¹, Robert Petryka², Jakub Słowik², Mirosław Jarosz²

Summary
Aim. The aim of the study was to present preliminary results of the palliative treatment of strictures and obstruction of the gastrointestinal tract in stage IV cancers with the use of self-expanding stents.
Material and methods. Within a one-year period, from October 2008 to September 2009, stent implantation in the gastrointestinal tract was performed in 32 patients. Eligibility for palliative treatment was determined on the basis of a clinical examination and diagnostic tests to assess cancer stage. Local advancement of cancer with infiltration of other tissues, such as metastases to the liver, distant lymph nodes or other organs, determined the choice of palliative treatment. The procedures were performed using a c-arm X-ray system and endoscope.
Results. A total of 33 stents were implanted in 32 patients. Problems with stent placement occurred in one patient. During implantation into a stricture secondary to sigmoid colon cancer, the stent slipped down and incompletely filled the tumor lumen. In this case, a short supplementary stent was added, which yielded a satisfactory result of the procedure. In another case, the stent migrated and adhered to the gastric wall, which further impaired passage through the patient′s gastrointestinal tract.
Conclusions. 1) Stent implantation in the gastrointestinal tract lumen in the setting of inoperable carcinomas under endoscopic and X-ray control is effective and safe. 2) In the case of gastrointestinal tract obstruction in patients with left colon cancers and in poor general condition, this procedure should be considered prior to pursuing surgical operations.

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