Gastric outlet obstruction in gastric cancer: A comparison of three palliative methods

Keränen, Ilona; Kylänpää, Leena; Udd, Marianne; Louhimo, Johanna; Lepistö, Anna; Halttunen, Jorma; Kokkola, Arto

doi:10.1002/jso.23442

Cited by 42 publications

(49 citation statements)

References 22 publications

(31 reference statements)

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“…[3][4][5][6][7] For patients with gastric cancer, surgical resection is not only the mainstay of radical treatment but also part of a multimodal therapeutic approach. [8][9][10] Postoperative complications may delay the initiation of postoperative treatment as well as lower patient quality of life. Tokunaga et al 11 have described the impact of postoperative abdominal complications on recurrence and overall survival in patients with gastric cancer.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Malnutrition Among Gastric Cancer Patients Undergoing Gastrectomy and Optimal Preoperative Nutritional Support for Preventing Surgical Site Infections

et al. 2015

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Section: Introductionmentioning

confidence: 99%

Prevalence of Malnutrition Among Gastric Cancer Patients Undergoing Gastrectomy and Optimal Preoperative Nutritional Support for Preventing Surgical Site Infections

et al. 2015

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“…Surgery is an important intervention in the treatment of gastric cancer with GOO [4], and the effects of this treatment are ideal, with symptom remission rates as high as 72% [9]. For patients undergoing surgery, pre-operative nutritional condition directly affects post-operative prognosis, overall survival, and disease-specific survival [10].…”

Section: Discussionmentioning

confidence: 99%

“…Often, coupled with this are long-term nutrient consumption problems, caused by most types of gastric cancer; thus, the vast majority of GOO patients have different degrees of malnutrition. Removal of the obstruction is the primary goal in the treatment of GOO patients, and the main method of treatment is surgery [4]. However, edema of the stomach and malnutrition lead to a decrease in the immune system, which increases the risk of peri-operative infection, poor healing of anastomotic and incision sites, and poor post-operative recovery, which also increases the risk of peri-operative pulmonary infection due to vomiting, causing aspiration into the lungs of patients with GOO [3].…”

Section: Introductionmentioning

confidence: 99%

The Effects of Pre-Operative Enteral Nutrition from Nasal Feeding Tubes on Gastric Outlet Obstruction

et al. 2017

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We examined gastric outlet obstruction (GOO) patients who received two weeks of strengthening pre-operative enteral nutrition therapy (pre-EN) through a nasal–jejenal feeding tube placed under a gastroscope to evaluate the feasibility and potential benefit of pre-EN compared to parenteral nutrition (PN). In this study, 68 patients confirmed to have GOO with upper-gastrointestinal contrast and who accepted the operation were randomized into an EN group and a PN group. The differences in nutritional status, immune function, post-operative complications, weight of patients, first bowel sound and first flatus time, pull tube time, length of hospital stay (LOH), and cost of hospitalization between pre-operation and post-operation were all recorded. Statistical analyses were performed using the chi square test and t-test; statistical significance was defined as p < 0.05. The success rate of the placement was 91.18% (three out of 31 cases). After pre-EN, the levels of weight, albumin (ALB), prealbumin (PA), and transferrin (TNF) in the EN group were significantly increased by pre-operation day compared to admission day, but were not significantly increased in the PN group; the weights in the EN group were significantly increased compared to the PN group by pre-operation day and day of discharge; total protein (TP), ALB, PA, and TNF of the EN group were significantly increased compared to the PN group on pre-operation and post-operative days one and three. The levels of CD3+, CD4+/CD8+, IgA, and IgM in the EN group were higher than those of the PN group at pre-operation and post-operation; the EN group had a significantly lower incidence of poor wound healing, peritoneal cavity infection, pneumonia, and a shorter first bowel sound time, first flatus time, and post-operation hospital stay than the PN group. Pre-EN through a nasal–jejunum feeding tube and placed under a gastroscope in GOO patients was safe, feasible, and beneficial to the nutrition status, immune function, and gastrointestinal function, and sped up recovery, while not increasing the cost of hospitalization.

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“…However, in cases of tumor obstruction, we have three palliative methods to cure the quality of patients' life, such as non-surgical methods like pyloric stenting or bypass operation and surgical resection. Keränen et al [22] reported that the median symptom-free and overall survival were longest in the resection group than stenting or bypass operation. And, they concluded palliative resection followed by chemotherapy is important to prolong the patients' survival.…”

Section: Discussionmentioning

confidence: 99%

Role of Surgery in the Management for Gastric Cancer with Synchronous Distant Metastases

Ikeguchi

Miyatani

Takaya

et al. 2015

Indian J Surg Oncol

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Optimal treatment of patients with gastric cancer with synchronous distant metastases is palliative chemotherapy. However, occasionally gastrectomy should be selected due to control bleeding from tumors, perforation, or obstruction. The aim of this study is to evaluate the survival benefits of non-curative gastrectomy for patients with synchronous distant metastasis. Total 78 gastric cancer patients with synchronous distant metastasis treated in our hospital between 2003 and 2012 were enrolled in this study. Of these, 74 patients (95 %) received S1 based chemotherapy. During the treatment, 37 patients (47.4 %) underwent palliative gastrectomy because of bleeding from tumors (n=15), tumor perforation (n=6), and obstruction (n=16). Survival benefits were compared in resected and non-resected patients, retrospectively. The two groups were clinicopathologically similar. Palliative gastrectomy was performed safely (morbidity: 10.8 % and mortality: 0) in resection group. However, resection showed survival benefits only in 13 patients (16.7 %) with single metastasis and without peritoneal metastasis. Their 2-year survival rate was 40 % and their median survival was 19 months. Non-curative gastrectomy with precise surgical techniques followed careful postoperative nutrition management may improve survival only for patients with a single metastatic site, except for peritoneal dissemination.

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Gastric outlet obstruction in gastric cancer: A comparison of three palliative methods

Cited by 42 publications

References 22 publications

Prevalence of Malnutrition Among Gastric Cancer Patients Undergoing Gastrectomy and Optimal Preoperative Nutritional Support for Preventing Surgical Site Infections

Prevalence of Malnutrition Among Gastric Cancer Patients Undergoing Gastrectomy and Optimal Preoperative Nutritional Support for Preventing Surgical Site Infections

The Effects of Pre-Operative Enteral Nutrition from Nasal Feeding Tubes on Gastric Outlet Obstruction

Role of Surgery in the Management for Gastric Cancer with Synchronous Distant Metastases

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