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The Palliative Effect of Endoscopic Uncovered Self-expandable Metallic Stent Placement Versus Gastrojejunostomy on Malignant Gastric Outlet Obstruction: A Pilot Study with a Retrospective Chart Review in Saga, Japan
OBJECTIVE: Endoscopic self-expandable metallic stent (SEMS) placement and gastrojejunostomy (GJY) are palliative treatments for malignant gastric outlet obstruction (GOO). The aim of the present study was to compare the palliative effects of these treatments and identify predictors of a poor oral in...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Japanese Society of Internal Medicine
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6028667/ https://www.ncbi.nlm.nih.gov/pubmed/29434131 http://dx.doi.org/10.2169/internalmedicine.0171-17 |
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author | Yukimoto, Takahiro Morisaki, Tomohito Komukai, Sho Yoshida, Hisako Yamaguchi, Daisuke Tsuruoka, Nanae Miyahara, Koichi Sakata, Yasuhisa Shibasaki, Shinichi Tsunada, Seiji Noda, Takahiro Yunotani, Seiji Fujimoto, Kazuma |
author_facet | Yukimoto, Takahiro Morisaki, Tomohito Komukai, Sho Yoshida, Hisako Yamaguchi, Daisuke Tsuruoka, Nanae Miyahara, Koichi Sakata, Yasuhisa Shibasaki, Shinichi Tsunada, Seiji Noda, Takahiro Yunotani, Seiji Fujimoto, Kazuma |
author_sort | Yukimoto, Takahiro |
collection | PubMed |
description | OBJECTIVE: Endoscopic self-expandable metallic stent (SEMS) placement and gastrojejunostomy (GJY) are palliative treatments for malignant gastric outlet obstruction (GOO). The aim of the present study was to compare the palliative effects of these treatments and identify predictors of a poor oral intake after treatment. METHODS AND PATIENTS: In total, 65 patients with GOO at multiple centers in Saga, Japan, were evaluated. Thirty-eight patients underwent SEMS placement, and 27 underwent GJY from January 2010 to December 2016. The characteristics and outcomes of the two groups were compared to detect predictors of treatment failure. RESULTS: No significant differences in the technical success, clinical success, post-treatment total protein, hospital discharge, duration from eating disability to death, or post-treatment overall survival were present between the SEMS and GJY groups. More patients in the GJY group than in the SEMS group received chemotherapy (51.4% vs. 26.3%, respectively; p=0.042). The period from treatment to the first meal was longer in the GJY group than in the SEMS group (4.5 vs. 3.0 days, respectively; p=0.013). The present study did not identify any risk factors for failure of SEMS placement. Although the stent length tended to be associated with a poor prognosis, the correlation was not statistically significant (odds ratio: 0.60, 95% confidence interval: 0.36-1.01, p=0.053). CONCLUSION: Patients with GOO started meals more promptly after SEMS than after GJY, but the clinical outcomes were not markedly different between the SEMS and GJY groups. These findings suggest that endoscopic uncovered SEMS placement might be a feasible palliative treatment for GOO. |
format | Online Article Text |
id | pubmed-6028667 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | The Japanese Society of Internal Medicine |
record_format | MEDLINE/PubMed |
spelling | pubmed-60286672018-07-03 The Palliative Effect of Endoscopic Uncovered Self-expandable Metallic Stent Placement Versus Gastrojejunostomy on Malignant Gastric Outlet Obstruction: A Pilot Study with a Retrospective Chart Review in Saga, Japan Yukimoto, Takahiro Morisaki, Tomohito Komukai, Sho Yoshida, Hisako Yamaguchi, Daisuke Tsuruoka, Nanae Miyahara, Koichi Sakata, Yasuhisa Shibasaki, Shinichi Tsunada, Seiji Noda, Takahiro Yunotani, Seiji Fujimoto, Kazuma Intern Med Original Article OBJECTIVE: Endoscopic self-expandable metallic stent (SEMS) placement and gastrojejunostomy (GJY) are palliative treatments for malignant gastric outlet obstruction (GOO). The aim of the present study was to compare the palliative effects of these treatments and identify predictors of a poor oral intake after treatment. METHODS AND PATIENTS: In total, 65 patients with GOO at multiple centers in Saga, Japan, were evaluated. Thirty-eight patients underwent SEMS placement, and 27 underwent GJY from January 2010 to December 2016. The characteristics and outcomes of the two groups were compared to detect predictors of treatment failure. RESULTS: No significant differences in the technical success, clinical success, post-treatment total protein, hospital discharge, duration from eating disability to death, or post-treatment overall survival were present between the SEMS and GJY groups. More patients in the GJY group than in the SEMS group received chemotherapy (51.4% vs. 26.3%, respectively; p=0.042). The period from treatment to the first meal was longer in the GJY group than in the SEMS group (4.5 vs. 3.0 days, respectively; p=0.013). The present study did not identify any risk factors for failure of SEMS placement. Although the stent length tended to be associated with a poor prognosis, the correlation was not statistically significant (odds ratio: 0.60, 95% confidence interval: 0.36-1.01, p=0.053). CONCLUSION: Patients with GOO started meals more promptly after SEMS than after GJY, but the clinical outcomes were not markedly different between the SEMS and GJY groups. These findings suggest that endoscopic uncovered SEMS placement might be a feasible palliative treatment for GOO. The Japanese Society of Internal Medicine 2018-02-09 2018-06-01 /pmc/articles/PMC6028667/ /pubmed/29434131 http://dx.doi.org/10.2169/internalmedicine.0171-17 Text en Copyright © 2018 by The Japanese Society of Internal Medicine https://creativecommons.org/licenses/by-nc-nd/4.0/ The Internal Medicine is an Open Access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Original Article Yukimoto, Takahiro Morisaki, Tomohito Komukai, Sho Yoshida, Hisako Yamaguchi, Daisuke Tsuruoka, Nanae Miyahara, Koichi Sakata, Yasuhisa Shibasaki, Shinichi Tsunada, Seiji Noda, Takahiro Yunotani, Seiji Fujimoto, Kazuma The Palliative Effect of Endoscopic Uncovered Self-expandable Metallic Stent Placement Versus Gastrojejunostomy on Malignant Gastric Outlet Obstruction: A Pilot Study with a Retrospective Chart Review in Saga, Japan |
title | The Palliative Effect of Endoscopic Uncovered Self-expandable Metallic Stent Placement Versus Gastrojejunostomy on Malignant Gastric Outlet Obstruction: A Pilot Study with a Retrospective Chart Review in Saga, Japan |
title_full | The Palliative Effect of Endoscopic Uncovered Self-expandable Metallic Stent Placement Versus Gastrojejunostomy on Malignant Gastric Outlet Obstruction: A Pilot Study with a Retrospective Chart Review in Saga, Japan |
title_fullStr | The Palliative Effect of Endoscopic Uncovered Self-expandable Metallic Stent Placement Versus Gastrojejunostomy on Malignant Gastric Outlet Obstruction: A Pilot Study with a Retrospective Chart Review in Saga, Japan |
title_full_unstemmed | The Palliative Effect of Endoscopic Uncovered Self-expandable Metallic Stent Placement Versus Gastrojejunostomy on Malignant Gastric Outlet Obstruction: A Pilot Study with a Retrospective Chart Review in Saga, Japan |
title_short | The Palliative Effect of Endoscopic Uncovered Self-expandable Metallic Stent Placement Versus Gastrojejunostomy on Malignant Gastric Outlet Obstruction: A Pilot Study with a Retrospective Chart Review in Saga, Japan |
title_sort | palliative effect of endoscopic uncovered self-expandable metallic stent placement versus gastrojejunostomy on malignant gastric outlet obstruction: a pilot study with a retrospective chart review in saga, japan |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6028667/ https://www.ncbi.nlm.nih.gov/pubmed/29434131 http://dx.doi.org/10.2169/internalmedicine.0171-17 |
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