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European Radiology
Published in: European Radiology 8/2016

01-08-2016 | Vascular-Interventional

Gastroduodenal stent placement versus surgical gastrojejunostomy for the palliation of gastric outlet obstructions in patients with unresectable gastric cancer: a propensity score-matched analysis

Authors: Jung-Hoon Park, Ho-Young Song, Sung-Cheol Yun, Moon-Won Yoo, Min-Hee Ryu, Jin Hyoung Kim, Do Hoon Kim, Jeong Hoon Lee, Wei-Zhong Zhou, Jeong Hwan Yook, Hwoon-Yong Jung

Published in: European Radiology | Issue 8/2016

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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
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Metadata
Title
Gastroduodenal stent placement versus surgical gastrojejunostomy for the palliation of gastric outlet obstructions in patients with unresectable gastric cancer: a propensity score-matched analysis
Authors
Jung-Hoon Park
Ho-Young Song
Sung-Cheol Yun
Moon-Won Yoo
Min-Hee Ryu
Jin Hyoung Kim
Do Hoon Kim
Jeong Hoon Lee
Wei-Zhong Zhou
Jeong Hwan Yook
Hwoon-Yong Jung
Publication date
01-08-2016
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 8/2016
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-015-4106-4

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