Effective New Stent Developed for Complictions of Gastrointestinal Cancer
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Date : 2016-07-11
Effective New Stent Developed for Complictions of Gastrointestinal Cancer
- Research team led by professor Sang Hyub Lee develops a new stent for treating malignant gastric outlet obstruction that enhance the strengths and overcome the weaknesses of original stents
A new effective stent was developed for malignant gastric outlet obstruction, which is a common complication appeared in gastrointestinal cancer patients.
Professor Sang Hyub Lee from department of gastroenterology in Seoul National University Hospital, in collaboration with research teams from Bundang Seoul National University Hospital, Asan Medical Center, Samsung Medical Center, Severance Hospital, Korea Cancer Center Hospital, published the results on the newest edition of internationally renowned American Journal of Gastroenterology (2015 Oct;110:1440-9, Impact factor=10.755).
Malignant gastric outlet obstruction is an illness which the cancer invades gastric outlet, causing strictures and closures, and impairs the passage of digested food. It is a common complication in gastrointestinal cancer patients and significantly worsens the patients quality of life.
Currently, a nonsurgical method inserting stents (a metal or plastic tube inserted into the lumen of whatever organ which keeps the lumen patent) using endoscope is a common practice. This specific treatment is to expand closed or narrowed lumen by inserting stents into the obstructive portion of stomach and/or duodenum.
The research team has developed a new stent named ‘WAVE (new covered SEMS with anti-migration properties’ that greatly improves the treatment efficacy.
WAVE is a covered SEMS (self-expandable metallic stent).
There are covered and uncovered types of SEMS. Covered types have wrapping films that prevents cancer from growing inside the stent. However, it is hard to fix these covered SEMS at a location. On the contrary, uncovered SEMS are easily fixed but always at risk of tumor ingrowth.
WAVE conserved strengths of both original covered and uncovered stents. First, the central body part of WAVE has a film that prevents ingrowth of cancer. To make the stents fixed, each end of WAVE has a film-less trumpet shape, with a dipping part at the center.
If the central ‘dipped’ part is located on the stricture of stomach and/or duodenum, the stent snaps and fixes in the appropriate portion of the stricture. Two lassos are at each end of WAVE that enables relocation of the stent even after the insertion.
The research team randomly assigned 102 patients into 2 groups (51 patients each), where the experimental group was treated with WAVE, and the control group was treated with conventional uncovered SEMS. These patients were observed for 16 weeks.
As a result, the experimental group (68.6%) showed significantly higher stent patency than that of the control group (41.2%).
Experimental group (7.1%) had greatly lower restenosis than the control group (37.7%). In terms of re-intervention frequency, experiment group (14.3%) was significantly lower than the control group (37.8%). There were no serious complications in both groups.
Especially, there wase no significant difference in the stent migration rate between the experimental group (9.5%) and the control group (5.4%). WAVE solved the stent migration problem, which is one of the most important weaknesses of covered SEMS.
Professor Sang Htyub Lee spoke, “With WAVE, for the first time in the world, we have proved that well designed covered SEMS can show better performance than uncovered SEMS. We expect WAVE will greatly contribute the quality of life and survival in patients with malignant gastric outlet obstruction.”
- Research team led by professor Sang Hyub Lee develops a new stent for treating malignant gastric outlet obstruction that enhance the strengths and overcome the weaknesses of original stents
A new effective stent was developed for malignant gastric outlet obstruction, which is a common complication appeared in gastrointestinal cancer patients.Professor Sang Hyub Lee from department of gastroenterology in Seoul National University Hospital, in collaboration with research teams from Bundang Seoul National University Hospital, Asan Medical Center, Samsung Medical Center, Severance Hospital, Korea Cancer Center Hospital, published the results on the newest edition of internationally renowned American Journal of Gastroenterology (2015 Oct;110:1440-9, Impact factor=10.755).
Malignant gastric outlet obstruction is an illness which the cancer invades gastric outlet, causing strictures and closures, and impairs the passage of digested food. It is a common complication in gastrointestinal cancer patients and significantly worsens the patients quality of life.
Currently, a nonsurgical method inserting stents (a metal or plastic tube inserted into the lumen of whatever organ which keeps the lumen patent) using endoscope is a common practice. This specific treatment is to expand closed or narrowed lumen by inserting stents into the obstructive portion of stomach and/or duodenum.
The research team has developed a new stent named ‘WAVE (new covered SEMS with anti-migration properties’ that greatly improves the treatment efficacy.
WAVE is a covered SEMS (self-expandable metallic stent).
There are covered and uncovered types of SEMS. Covered types have wrapping films that prevents cancer from growing inside the stent. However, it is hard to fix these covered SEMS at a location. On the contrary, uncovered SEMS are easily fixed but always at risk of tumor ingrowth.
WAVE conserved strengths of both original covered and uncovered stents. First, the central body part of WAVE has a film that prevents ingrowth of cancer. To make the stents fixed, each end of WAVE has a film-less trumpet shape, with a dipping part at the center.
If the central ‘dipped’ part is located on the stricture of stomach and/or duodenum, the stent snaps and fixes in the appropriate portion of the stricture. Two lassos are at each end of WAVE that enables relocation of the stent even after the insertion.
The research team randomly assigned 102 patients into 2 groups (51 patients each), where the experimental group was treated with WAVE, and the control group was treated with conventional uncovered SEMS. These patients were observed for 16 weeks.
As a result, the experimental group (68.6%) showed significantly higher stent patency than that of the control group (41.2%).
Experimental group (7.1%) had greatly lower restenosis than the control group (37.7%). In terms of re-intervention frequency, experiment group (14.3%) was significantly lower than the control group (37.8%). There were no serious complications in both groups.
Especially, there wase no significant difference in the stent migration rate between the experimental group (9.5%) and the control group (5.4%). WAVE solved the stent migration problem, which is one of the most important weaknesses of covered SEMS.
Professor Sang Htyub Lee spoke, “With WAVE, for the first time in the world, we have proved that well designed covered SEMS can show better performance than uncovered SEMS. We expect WAVE will greatly contribute the quality of life and survival in patients with malignant gastric outlet obstruction.”