Is a small-caliber or large-caliber endoscope more suitable for colonic self-expandable metallic stent placement? A randomized controlled study

Yosuke Minoda, Haruei Ogino, Yorinobu Sumida, Takashi Osoegawa, Soichi Itaba, Norikazu Hashimoto, Mitsuru Esaki, Yusuke Kitagawa, Kentaro Yodoe, Yoichiro Iboshi, Takahiro Matsuguchi, Mei Tadokoro, Tomohito Chaen, Hiroaki Kubo, Masaru Kubokawa, Naohiko Harada, Kenichi Nishizima, Hiroyuki Fujii, Yoshitaka Hata, Yoshimasa TanakaEikichi Ihara, Yoshihiro Ogawa

研究成果: ジャーナルへの寄稿学術誌査読

抄録

Objectives: The colonic self-expandable metallic stent (C-SEMS) with a 9-French (Fr) delivery system allows for a small-caliber endoscope (SCE) to be used to treat malignant colonic obstruction. Despite the lack of evidence, the SCE has become popular because it is considered easier to insert than the large-caliber endoscope (LCE). We aimed to determine whether the SCE is more suitable than the LCE for C-SEMS placement. Methods: Between July 2018 and November 2019, 50 consecutive patients who were scheduled to undergo C-SEMS for colon obstruction were recruited in this study. Patients were randomized to the SCE or LCE group. The SCE and LCE were used with 9-Fr and 10-Fr delivery systems, respectively. The primary outcome was the total procedure time. Secondary outcomes were the technical success rate, complication rate, clinical success rate, insertion time, guidewire-passage time, stent-deployment time, and colonic obstruction-scoring-system score. Results: Forty-five patients (SCE group, n = 22; LCE group, n = 23) were analyzed. The procedure time in the LCE group (median, 20.5 min) was significantly (p = 0.024) shorter than that in the SCE group (median, 25.1 min). The insertion time in the LCE group (median, 2.0 min) was significantly (p = 0.0049) shorter than that in the SCE group (median, 6.0 min). A sub-analysis of the procedure difficulties showed that the insertion time in the LCE group (median, 5.0 min) was significantly shorter than that in the SCE group (median, 8.5 min). Conclusion: Both LCE and SCE can be used for C-SEMS; however, LCE is more suitable than SCE as it achieved a faster and equally efficacious C-SEMS placement as that of SCE. Clinical trial registration number: University Hospital Medical Information Network Clinical Trials Registry (UMIN 32748).

本文言語英語
ジャーナルTherapeutic Advances in Gastroenterology
15
DOI
出版ステータス出版済み - 1月 2022

!!!All Science Journal Classification (ASJC) codes

  • 消化器病学

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