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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society of Internal Medicine 2018
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.
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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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