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Treatment option of endoscopic stent insertion or gastrojejunostomy for gastric outlet obstruction due to gastric cancer: a propensity score-matched analysis.
- Source :
-
Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association [Gastric Cancer] 2020 Jul; Vol. 23 (4), pp. 667-676. Date of Electronic Publication: 2020 Jan 25. - Publication Year :
- 2020
-
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.<br />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.<br />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).<br />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.
- Subjects :
- Adult
Aged
Aged, 80 and over
Female
Follow-Up Studies
Gastric Outlet Obstruction etiology
Gastric Outlet Obstruction pathology
Humans
Length of Stay
Male
Middle Aged
Prognosis
Retrospective Studies
Endoscopy methods
Gastric Bypass methods
Gastric Outlet Obstruction surgery
Palliative Care
Stents
Stomach Neoplasms complications
Subjects
Details
- Language :
- English
- ISSN :
- 1436-3305
- Volume :
- 23
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association
- Publication Type :
- Academic Journal
- Accession number :
- 31982964
- Full Text :
- https://doi.org/10.1007/s10120-020-01040-0