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1.
Gut and Liver ; : 47-54, 2017.
Artigo em Inglês | WPRIM | ID: wpr-100545

RESUMO

BACKGROUND/AIMS: Self-expandable metallic stent (SEMS) placement is effective for dysphagia that results from malignant obstruction of the esophagus or gastric cardia; however, stent-related complications may be life-threatening. Thus, the goal of this study was to identify risk factors associated with complications following esophageal stenting. METHODS: Of the 71 patients who underwent SEMS placement for dysphagia as a result of malignant stricture of the esophagus or gastric cardia, 53 patients with squamous cell carcinoma or adenocarcinoma, without previous SEMS placement, without a fistula, and without recurrent tumor after surgery were retrospectively identified. The occurrence of stent-related complications was used as an endpoint. RESULTS: Stent-related complications were identified in 26 patients (49.1%), and major complications occurred in 14 patients (26.4%). The use of an Ultraflex stent (odds ratio [OR], 6.81; 95% confidence interval [CI], 1.54 to 30.00; p=0.011) and prior chemotherapy (OR, 6.13; 95% CI, 1.46 to 25.70; p=0.013) were significantly associated with stent-related complications. Moreover, the use of an Ultraflex stent (OR, 19.60; 95% CI, 2.26 to 170.00; p=0.007) and prior radiation (OR, 25.70; 95% CI, 2.37 to 280.00; p=0.008) significantly increased the risk of major complications. CONCLUSIONS: The use of an Ultraflex stent and prior radiation and/or chemotherapy may represent risk factors for complications following esophageal SEMS placement.


Assuntos
Humanos , Adenocarcinoma , Carcinoma de Células Escamosas , Cárdia , Constrição Patológica , Transtornos de Deglutição , Tratamento Farmacológico , Esôfago , Fístula , Estudos Retrospectivos , Fatores de Risco , Stents
2.
Gut and Liver ; : 51-57, 2016.
Artigo em Inglês | WPRIM | ID: wpr-111618

RESUMO

BACKGROUND/AIMS: A barbed puncture needle with a side hole was recently developed to improve sample quality and quantity in endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). In this study, we retrospectively assessed the usefulness of this puncture needle. METHODS: Factors affecting diagnostic yield, safety, and diagnostic accuracy were investigated in 76 patients who consecutively underwent EUS-FNA for neoplastic lesions at our hospital between January and December 2013. RESULTS: The procedure was successful in all cases; the rates of sample collection and determination of the correct diagnosis were 92.1% and 89.5%, respectively. The mean number of needle passes required for diagnosis was 1.1. Complications included mild intraluminal bleeding in two patients (2.6%). Multivariate analysis revealed that lesion size (< or =20 mm) was significantly associated with a decreased chance of determining the correct diagnosis. CONCLUSIONS: Core biopsy needles with a side hole are safe and provide a satisfactory diagnostic yield. However, the side hole may potentially reduce the rate of making the correct diagnosis in small lesions.


Assuntos
Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias do Sistema Digestório/diagnóstico , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico/instrumentação , Desenho de Equipamento , Segurança de Equipamentos , Trato Gastrointestinal/patologia , Análise Multivariada , Agulhas/efeitos adversos , Valor Preditivo dos Testes , Estudos Retrospectivos , Sensibilidade e Especificidade , Estatísticas não Paramétricas
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