论文部分内容阅读
Background. In patients with gastric outlet obstruction (GOO), palliative enteral stenting is a less invasive procedure compared with gastroenterostomy. Most diseases analyzed in previous studies of such stenting were pancreaticobiliary m alignancies. Methods. We reviewed the medical records of patients with GOO secon dary to gastric cancer who were admitted to our institution between September 19 94 and September 2004. The outcome of stent placement for GOO was compared with the outcome in patients who underwent palliative open gastrojejunostomy during t he same period. Enrolled patients from both groups displayed symptomatic GOO. Pa tients with recurrent gastric cancer were excluded from this study. Results. Twe nty-two patients underwent palliative enteral stenting, and 22 patients were su bjected to surgical gastrojejunostomy (bypass). There were no significant differ ences between the two groups regarding patient baseline characteristics. Technic al success and clinical success were obtained in 100%and 77.3%, respectively, of both groups. The operating time was shorter in the stent group (30 vs 118 min ; P < 0.0001). The time from the procedure to the resumption of food intake was shorter in the stent group than in the bypass group (2 days vs 8 days; P < 0.000 1). An improvement in performance score after the procedure was observed in both groups (stent group; P = 0.0264; bypass group; P = 0.0235). No significant diff erences were observed regarding the possibility of discharge. In patients discha rged, the median postoperative hospital stays were 19 days and 28 days (P = 0.05 58). The median survival periods were 65 days and 90 days. Minor complications w ere observed in 1 patient in the stent group and in 4 in the bypass group. No mo rtality or severe complications were observed for either group. Conclusions. Sel f-expandable metallic stent placement is a safe and efficacious procedure for p alliation, with shorter operating time and more prompt restoration of oral intak e, compared to surgical alternatives in patients with GOO caused by gastric canc er.
Background. In patients with gastric outlet obstruction (GOO), palliative enteral stenting is a less invasive procedure than with gastroenterostomy. dary to gastric cancer who were admitted to our institution between September 19 94 and September 2004. The outcome of stent placement for GOO was compared with the outcome in patients who underwent palliative open gastrojejunostomy during t he same period. Enrolled patients from both groups displayed symptomatic G00. Pa tients with recurrent gastric cancer were excluded from this study. Results. Twe nty-two patients underwent palliative enteral stenting, and 22 patients were su bjected to surgical gastrojejunostomy (bypass). There were no significant differncencesbetween the two groups regarding patient baseline characteristics. Technic al success and clinical success we The operating time was shorter in the stent group (30 vs 118 min; P <0.0001). The time from the procedure to the resumption of food intake was shorter in the The stent group than in the bypass group (2 days vs 8 days; P <0.0001). An improvement in performance score after the procedure was observed in both groups (stent group; P = 0.0264; bypass group; P = 0.0235) Significant diff erences were observed regarding the possibility of discharge. In patients dischaged, the median postoperative hospital stays were 19 days and 28 days (P = 0.05 58). The median survival periods were 65 days and 90 days. in 1 patient in the stent group and in 4 in the bypass group. No mo rtality or severe complications were observed for either group. Conclusions. Sel f-expandable metallic stent placement is a safe and efficacious procedure for p alliation, with shorter operating time and more prompt restoration of oral intak e, compared to surgical alternatives in patients with GOO caused by gastric canc er.