腹腔镜胃空肠吻合术与十二指肠支架置入术治疗恶性胃流出道梗阻的前瞻性随机试验
Prospective randomized trial of laparoscopic gastrojejunostomy versus duodenal stenting for malignant gastric outflow obstruction.
作者信息
Mehta S, Hindmarsh A, Cheong E, Cockburn J, Saada J, Tighe R, Lewis M P N, Rhodes M
机构信息
Department of Upper Gastrointestinal Surgery, Norfolk and Norwich University Hospital, Colney Lane, Norwich, England, United Kingdom.
出版信息
Surg Endosc. 2006 Feb;20(2):239-42. doi: 10.1007/s00464-005-0130-9. Epub 2005 Dec 9.
BACKGROUND
We prospectively compared laparoscopic gastrojejunostomy with duodenal stenting as a means of palliating malignant gastric outflow obstruction.
METHODS
A total of 27 patients with malignant gastric outflow obstruction were randomized to either laparoscopic gastrojejunostomy (LGJ) or duodenal stenting (DS) over a 3-year period.
RESULTS
Thirteen patients underwent successful LGJ and 10 had successful DS. Eight patients had complications after LGJ, but none had complications after DS. Patients who underwent LGJ had a significant increase in visual analog pain score at day 1 (p = 0.05), and also had a longer hospital stay compared to those who underwent DS (11.4 vs. 5.2 days, p = 0.02). After DS, patients experienced an improvement in physical health at 1 month as measured using the Short Form-36 (SF-36) questionnaire (p < 0.01). There was no change following LGJ.
CONCLUSION
Duodenal stenting is a safe means of palliating malignant gastric outflow obstruction. It offers significant advantages for patients compared with minimal-access surgery.
背景
我们前瞻性地比较了腹腔镜胃空肠吻合术与十二指肠支架置入术作为缓解恶性胃流出道梗阻的手段。
方法
在3年的时间里，共有27例恶性胃流出道梗阻患者被随机分为腹腔镜胃空肠吻合术（LGJ）组或十二指肠支架置入术（DS）组。
结果
13例患者成功接受了LGJ，10例成功接受了DS。8例患者在LGJ后出现并发症，但DS后无一例出现并发症。接受LGJ的患者在第1天视觉模拟疼痛评分显著增加（p = 0.05），与接受DS的患者相比，住院时间也更长（11.4天对5.2天，p = 0.02）。DS后，使用简短健康调查问卷（SF-36）测量，患者在1个月时身体健康状况有所改善（p < 0.01）。LGJ后无变化。
结论
十二指肠支架置入术是缓解恶性胃流出道梗阻的一种安全手段。与微创手术相比，它为患者提供了显著的优势。
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