{"title":"胃肠腔内支架植入术:美国早期十二指肠HANAROSTENT的经验。","authors":"Brian M Fung, Brian E Kadera, James H Tabibian","doi":"10.1159/000510350","DOIUrl":null,"url":null,"abstract":"<p><p>Self-expandable metal stents (SEMSs) are frequently utilized for palliation of malignant gastric and/or duodenal outlet obstruction (GDOO). Re-establishing luminal patency with accurate SEMS positioning while limiting migration and adjacent tissue injury is an important technical consideration and aim. The duodenal HANAROSTENT<sup>®</sup> was introduced in the USA in 2019 and developed with these challenges in mind. As the first center in the USA to deploy the duo-denal HANAROSTENT<sup>®</sup> in clinical practice, we herein examine our early experience with its use. Specifically, we describe 7 consecutive cases of malignant GDOO in which a duodenal HANAROSTENT<sup>®</sup> was placed for on-label use, defined as palliative treatment of malignant gastric and/or duodenal obstruction. All stents were 22 mm in diameter, with 5 being 90 mm and 2 being 120 mm in length. Technical and clinical success with duodenal HANAROSTENT<sup>®</sup> placement were achieved in all 7 cases (100%). In no case was stent adjustment required post-deployment. There were no stent-related adverse events, and no subsequent endoscopic procedures were necessary in any of the patients during a mean follow-up of 5 months (range 1-12 months). In summary, the duodenal HANAROSTENT<sup>®</sup> appears to perform well and be a promising alternative to other available duodenal SEMSs. As experience in the USA with this newly introduced duodenal SEMS grows, multicenter prospective data should be collected to better establish its relative safety and efficacy.</p>","PeriodicalId":45017,"journal":{"name":"Gastrointestinal Tumors","volume":"8 1","pages":"1-7"},"PeriodicalIF":0.8000,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000510350","citationCount":"0","resultStr":"{\"title\":\"Gastrointestinal Luminal Stenting: The Early US Experience with the Duodenal HANAROSTENT.\",\"authors\":\"Brian M Fung, Brian E Kadera, James H Tabibian\",\"doi\":\"10.1159/000510350\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Self-expandable metal stents (SEMSs) are frequently utilized for palliation of malignant gastric and/or duodenal outlet obstruction (GDOO). Re-establishing luminal patency with accurate SEMS positioning while limiting migration and adjacent tissue injury is an important technical consideration and aim. The duodenal HANAROSTENT<sup>®</sup> was introduced in the USA in 2019 and developed with these challenges in mind. As the first center in the USA to deploy the duo-denal HANAROSTENT<sup>®</sup> in clinical practice, we herein examine our early experience with its use. Specifically, we describe 7 consecutive cases of malignant GDOO in which a duodenal HANAROSTENT<sup>®</sup> was placed for on-label use, defined as palliative treatment of malignant gastric and/or duodenal obstruction. All stents were 22 mm in diameter, with 5 being 90 mm and 2 being 120 mm in length. Technical and clinical success with duodenal HANAROSTENT<sup>®</sup> placement were achieved in all 7 cases (100%). In no case was stent adjustment required post-deployment. There were no stent-related adverse events, and no subsequent endoscopic procedures were necessary in any of the patients during a mean follow-up of 5 months (range 1-12 months). In summary, the duodenal HANAROSTENT<sup>®</sup> appears to perform well and be a promising alternative to other available duodenal SEMSs. As experience in the USA with this newly introduced duodenal SEMS grows, multicenter prospective data should be collected to better establish its relative safety and efficacy.</p>\",\"PeriodicalId\":45017,\"journal\":{\"name\":\"Gastrointestinal Tumors\",\"volume\":\"8 1\",\"pages\":\"1-7\"},\"PeriodicalIF\":0.8000,\"publicationDate\":\"2021-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1159/000510350\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Gastrointestinal Tumors\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1159/000510350\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2020/10/9 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Gastrointestinal Tumors","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1159/000510350","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2020/10/9 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
自膨胀金属支架(SEMSs)常用于缓解恶性胃和/或十二指肠出口梗阻(GDOO)。通过精确的SEMS定位重建腔内通畅,同时限制移位和邻近组织损伤是重要的技术考虑和目标。十二指肠HANAROSTENT®于2019年在美国推出,并考虑到这些挑战而开发。作为美国第一个在临床实践中部署双牙HANAROSTENT®的中心,我们在此研究我们使用它的早期经验。具体来说,我们描述了连续7例恶性GDOO,其中十二指肠HANAROSTENT®用于标签上的使用,定义为恶性胃和/或十二指肠梗阻的姑息性治疗。所有支架直径为22 mm,其中5个为90 mm, 2个为120 mm。所有7例(100%)十二指肠HANAROSTENT®放置的技术和临床成功。在任何情况下,支架部署后都不需要调整。在平均5个月(1-12个月)的随访期间,没有发生支架相关的不良事件,也没有后续的内镜手术。综上所述,十二指肠HANAROSTENT®表现良好,是一种有希望的替代其他可用的十二指肠SEMSs。随着美国对这种新引入的十二指肠SEMS的经验不断增加,需要收集多中心前瞻性数据以更好地确定其相对安全性和有效性。
Gastrointestinal Luminal Stenting: The Early US Experience with the Duodenal HANAROSTENT.
Self-expandable metal stents (SEMSs) are frequently utilized for palliation of malignant gastric and/or duodenal outlet obstruction (GDOO). Re-establishing luminal patency with accurate SEMS positioning while limiting migration and adjacent tissue injury is an important technical consideration and aim. The duodenal HANAROSTENT® was introduced in the USA in 2019 and developed with these challenges in mind. As the first center in the USA to deploy the duo-denal HANAROSTENT® in clinical practice, we herein examine our early experience with its use. Specifically, we describe 7 consecutive cases of malignant GDOO in which a duodenal HANAROSTENT® was placed for on-label use, defined as palliative treatment of malignant gastric and/or duodenal obstruction. All stents were 22 mm in diameter, with 5 being 90 mm and 2 being 120 mm in length. Technical and clinical success with duodenal HANAROSTENT® placement were achieved in all 7 cases (100%). In no case was stent adjustment required post-deployment. There were no stent-related adverse events, and no subsequent endoscopic procedures were necessary in any of the patients during a mean follow-up of 5 months (range 1-12 months). In summary, the duodenal HANAROSTENT® appears to perform well and be a promising alternative to other available duodenal SEMSs. As experience in the USA with this newly introduced duodenal SEMS grows, multicenter prospective data should be collected to better establish its relative safety and efficacy.