ORIGINAL RESEARCH article
Front. Oncol.
Sec. Gastrointestinal Cancers: Gastric and Esophageal Cancers
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1599582
Clinical Utility of Self-Expandable Metal Stents in the Treatment of Anastomotic Obstruction Secondary to Recurrent Gastric Cancer
Provisionally accepted
- The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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The purpose of this study was to assess the efficacy and safety of self-expandable metal stents (SEMS) in treating anastomotic obstruction associated with recurrent gastric cancer.Methods: Ten patients with anastomotic obstruction in recurrent gastric cancer were treated by SEMS implantation under fluoroscopic guidance. All patients presented with refractory nausea, vomiting and complete inability to tolerate oral intake before stent placement, requiring total parenteral nutrition (TPN). Clinical data were retrospectively analyzed the technical and clinical success rates, stent patency and complication rates.Results: SEMS was successfully implanted in all patients, and clinical success rate was 100%. The operations were subtotal gastrectomy with Billroth-Ⅱ reconstruction (n = 3), radical distal gastrectomy (n = 3), total gastrectomy with esophagojejunostomy (n = 3), and palliative gastrojejunostomy (n = 1). Three patients developed stent occlusion due to intrastent tumor ingrowth secondary to disease progression after initial anastomotic stent placement, and underwent secondary stent 3 / 22 implantation with successful maintenance of patency postoperatively. One patient developed stent obstruction due to food impaction on postoperative day 10, which was managed endoscopically with successful restoration and maintenance of luminal patency. The mean stent patency was 78 d (range, 8-225 d). No serious complications, such as anastomotic leakage, stent migration and bleeding were observed in these patients.Fluoroscopically-guided SEMS placement represents a technically safe and clinically effective intervention for managing anastomotic obstructions in recurrent gastric cancer. SEMS placement offers rapid symptom relief, shorter hospital stays, and improved quality of life compared to surgical alternatives in this patient population. Thus, based on its technical feasibility and clinical outcomes, this method warrants primary consideration in palliative treatment algorithms.
Keywords: Anastomotic obstruction, Self-expandable metal stents, gastric cancer, gastrojejunostomy, Esophagojejunostomy
Received: 25 Mar 2025; Accepted: 30 May 2025.
Copyright: © 2025 Lai, Wu, Liu, Li, Peng, Wan and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Bo Zhang, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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