AI Article Synopsis
- The study aimed to compare the effectiveness of two treatment options for gastric outlet obstruction (GOO) caused by gastric cancer: endoscopic stenting and surgical gastrojejunostomy.
- Data was collected from 179 patients across 42 hospitals, showing that patients who received stents had fewer postoperative complications, but the survival times were similar for both treatment groups.
- Overall, endoscopic stenting appears to be a viable option, resulting in less morbidity while maintaining similar food intake and survival times compared to gastrojejunostomy.
Article Abstract
Background: There are currently two treatment options for gastric outlet obstruction (GOO) due to gastric cancer, endoscopic stenting and surgical gastrojejunostomy. However, their therapeutic effects have not yet been established. Therefore, the present study was undertaken to examine these effects.
Methods: The Japanese Gastric Cancer Association invited its delegates to participate in a retrospective multicenter cohort study on patients with GOO due to gastric cancer who underwent stent therapy or gastrojejunostomy in 2015.
Results: We obtained data from 85 patients undergoing stent therapy and 94 undergoing gastrojejunostomy from 42 hospitals. Baseline data revealed that stent patients had lower food intake, poorer performance status, and worse prognostic indices than gastrojejunostomy patients. Postoperative food intake and survival times were worse in stent patients than in gastrojejunostomy patients. We performed propensity score matching to select pairs of patients with similar baseline characteristics in the two treatment groups. After matching, the frequency of postoperative complications was significantly less in stent patients (3%, 1/33) than in gastrojejunostomy patients (21%, 7/34; p = 0.03). A low residue or full diet was achieved by 97% of stent patients (32/33) and 97% of gastrojejunostomy patients (33/34) (p = 0.98). Median survival times were 7.8 months in stent patients and 4.0 months in gastrojejunostomy patients (p = 0.38).
Conclusions: Propensity score matching demonstrated that endoscopic stent placement resulted in less postoperative morbidity than and a similar food intake and equivalent survival times to gastrojejunostomy. These results suggest the utility of stent therapy.
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| http://dx.doi.org/10.1007/s10120-020-01040-0 | DOI Listing |
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