Enteral self-expandable metal stent for malignant luminal obstruction of the upper and lower gastrointestinal tract: a prospective multicentric study.

Background: Self-expanding metal stents (SEMSs) are used to treat malignant stenosis of the gastrointestinal (GI) tract, as a safe, feasible, and minimally invasive option for reestablishing luminal patency. However, the literature offers scant prospective data on the clinical outcome of these patients. Aim: To assess the technical success, complications, and clinical outcomes of patients with a SEMS placed for malignant upper and lower GI obstruction. Patients and Methods: A cohort of 110 patients with clinical symptoms related to malignant stenosis of the upper and lower GI tract were prospectively enrolled and SEMSs were placed endoscopically in 9 endoscopy centers. The patients were followed up and survival, oral intake, stool canalization, and late complications were recorded on days 30, 90, and 180. Results: Overall, 110 patients, 38 (34.5%) with upper and 72 (65.5%) with lower GI obstruction were examined. The procedure was successful in 102 (92.7%). There were 5 early complications ( 96h) occurred in 6 patients (6.3%). Median survival after stenting was 90 days (ql 30; q3 120). Placing the SEMS enabled 79.4%, 90.9%, and 100% of the patients to resume an oral diet at 30, 90, and 180 days, respectively. All patients had stool canalization until death. Conclusions: Endoscopic stenting is an effective and safe procedure for malignant luminal obstruction of the GI tract, with good clinical outcomes in patients whose survival is unfortunately short.