1. Gastroduodenal stent placement versus surgical gastrojejunostomy for the palliation of gastric outlet obstructions in patients with unresectable gastric cancer: a propensity score-matched analysis.
- Author
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Park, Jung-Hoon, Song, Ho-Young, Yun, Sung-Cheol, Yoo, Moon-Won, Ryu, Min-Hee, Kim, Jin, Kim, Do, Lee, Jeong, Zhou, Wei-Zhong, Yook, Jeong, Jung, Hwoon-Yong, Kim, Jin Hyoung, Kim, Do Hoon, Lee, Jeong Hoon, and Yook, Jeong Hwan
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GASTRIC outlet obstruction , *GASTRODUODENOSTOMY , *STOMACH cancer treatment , *GASTRIC bypass , *PALLIATIVE treatment , *SURGICAL stents , *THERAPEUTICS , *COMPARATIVE studies , *RESEARCH methodology , *MEDICAL cooperation , *RESEARCH , *STOMACH tumors , *SURVIVAL analysis (Biometry) , *EVALUATION research , *RETROSPECTIVE studies , *DISEASE complications - Abstract
Objectives: To compare the outcomes between stent placement and surgical gastrojejunostomy (GJ) for the palliation of gastric outlet obstruction (GOO) in patients with unresectable gastric cancer.Methods: A retrospective study was performed in a single university hospital in 224 patients with GOO, and who were treated either by stent placement (n = 124) or surgical GJ (n = 100). The outcomes were assessed with reference to the following variables with the use of propensity-score matching: success rates; complications; dysphagia scores, albumin, and body mass index; survival; symptom-free duration; and hospitalization.Results: We identified a well-balanced cohort of 74 pairs of patients, matched on the basis of propensity score. The dysphagia score 7 days after treatment was significantly better in the stent group (P < 0.001). Albumin level 1 month after treatment was significantly lower in the stent group (P < 0.001). Symptom-free duration and hospitalization were significantly longer in the surgery group (P = 0.002, P < 0.001, respectively). The recurrence rate was significantly higher in the stent group (P = 0.032).Conclusions: Stent placement can provide faster symptom relief and shorter hospitalization, while surgical GJ can provide longer symptom-free duration, less recurrent obstruction symptoms and better nutritional status.Key Points: • The two methods are equally effective in palliating gastric outlet obstruction symptoms • The stent group showed rapid and efficient palliation of symptoms • Recurrent symptoms were more frequent in the stent group • Surgical gastrojejunostomy provides a longer symptom-free duration and better nutritional status. [ABSTRACT FROM AUTHOR]- Published
- 2016
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