TY - JOUR T1 - Endoscopic placement of covered versus uncovered self-expandable metal stents for palliation of malignant gastric outlet obstruction JF - Gut JO - Gut SP - 1244 LP - 1252 DO - 10.1136/gutjnl-2020-320775 VL - 70 IS - 7 AU - Kentaro Yamao AU - Masayuki Kitano AU - Yasutaka Chiba AU - Takeshi Ogura AU - Takaaki Eguchi AU - Ichiro Moriyama AU - Yukitaka Yamashita AU - Hironari Kato AU - Takahisa Kayahara AU - Noriyuki Hoki AU - Yoshinobu Okabe AU - Hideyuki Shiomi AU - Yoshitaka Nakai AU - Yoshinori Kushiyama AU - Yoshifumi Fujimoto AU - Shiro Hayashi AU - Shigeki Bamba AU - Yasushi Kudo AU - Nobuaki Azemoto AU - Toshiharu Ueki AU - Norimitsu Uza AU - Masanori Asada AU - Kazuya Matsumoto AU - Hiroko Nebiki AU - Hiroshi Takihara AU - Chisio Noguchi AU - Hideki Kamada AU - Kojiro Nakase AU - Daisuke Goto AU - Tsuyoshi Sanuki AU - Tetsuya Koga AU - Shinichi Hashimoto AU - Hidefumi Nishikiori AU - Masahiro Serikawa AU - Keiji Hanada AU - Ken Hirao AU - Masaya Ohana AU - Imakiire Kazuyuki AU - Takao Kato AU - Motoyuki Yoshida AU - Hirofumi Kawamoto Y1 - 2021/07/01 UR - http://gut.bmj.com/content/70/7/1244.abstract N2 - Objective Stenting is an established endoscopic therapy for malignant gastric outlet obstruction (mGOO). The choice of stent (covered vs uncovered) has been examined in prior randomised studies without clear results.Design In a multicentre randomised prospective study, we compared covered (CSEMS) with uncovered self-expandable metal stents (UCSEMS) in patients with mGOO; main outcomes were stent dysfunction and patient survival, with subgroup analyses of patients with extrinsic and intrinsic tumours.Results Overall survival was poor with no difference between groups (probability at 3 months 49.7% for covered vs 48.4% for uncovered stents; log-rank for overall survival p=0.26). Within that setting of short survival, the proportion of stent dysfunction was significantly higher for uncovered stents (35.2% vs 23.4%, p=0.01) with significantly shorter time to stent dysfunction. This was mainly relevant for patients with extrinsic tumours (stent dysfunction rates for uncovered stents 35.6% vs 17.5%, p<0.01). Subgrouping was also relevant with respect to tumour ingrowth (lower with covered stents for intrinsic tumours; 1.6% vs 27.7%, p<0.01) and stent migration (higher with covered stents for extrinsic tumours: 15.3% vs 2.5%, p<0.01).Conclusions Due to poor patient survival, minor differences between covered and uncovered stents may be less relevant even if statistically significant; however, subgroup analysis would suggest to use covered stents for intrinsic and uncovered stents for extrinsic malignancies.Data are available upon reasonable request. We are ready to respond to any inquiries about the detailed data in this study. ER -