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恶性胃出口梗阻内镜支架置入术后并发症:一项队列研究

Complications After Endoscopic Stenting for Malignant Gastric Outlet Obstruction: A Cohort Study.

作者信息

Sterpetti Antonio V, Fiori Enrico, Sapienza Paolo, Lamazza Antonietta

机构信息

Policlinico Umberto I, University of Rome Sapienza, Rome, Italy.

出版信息

Surg Laparosc Endosc Percutan Tech. 2019 Jun;29(3):169-172. doi: 10.1097/SLE.0000000000000656.

Abstract

BACKGROUND

Gastric stenting has become a common place in clinical practice. The aim of our study was to evaluate the factors influencing the clinical outcome in patients who received endoscopic stenting for malignant gastric outlet obstruction (GOO).

MATERIALS AND METHODS

We prospectively evaluated the clinical course of 87 patients who presented to our attention with malignant GOO.

RESULTS

There was neither mortality nor major morbidity after endoscopic stenting. Survival was reduced (average, 2 mo) in patients with an obstruction due to no resectable pancreatic cancer. In patients with primary no resectable pyloric adenocarcinoma, the crude survival was >1 year. Almost half of the patients required a new endoscopy. Food obstruction was common after 6 months from stent placement, limiting the quality of life of the patients.

CONCLUSIONS

Endoscopic stenting represents a valid treatment in patients with symptoms of GOO from metastatic cancer. Patients with metastatic pyloric adenocarcinoma and normal liver function tests have survival rates longer than 1 year. In this selected group of patients, laparoscopic surgical gastrojejunostomy can be a valid alternative to avoid a close and exhausting follow-up, with the possibility of a better quality of life (res Registry 808).

摘要

背景

胃支架置入术已成为临床实践中的常见操作。我们研究的目的是评估影响接受内镜下支架置入术治疗恶性胃出口梗阻(GOO)患者临床结局的因素。

材料与方法

我们前瞻性评估了87例因恶性GOO前来就诊患者的临床病程。

结果

内镜下支架置入术后既无死亡病例也无严重并发症。因不可切除胰腺癌导致梗阻的患者生存期缩短(平均2个月)。原发性不可切除幽门腺癌患者的粗生存率>1年。几乎一半的患者需要再次进行内镜检查。支架置入6个月后食物梗阻很常见,限制了患者的生活质量。

结论

内镜下支架置入术是转移性癌症导致GOO症状患者的有效治疗方法。转移性幽门腺癌且肝功能检查正常的患者生存率超过1年。在这一特定患者群体中,腹腔镜手术胃空肠吻合术可以作为一种有效的替代方法,以避免密切且令人疲惫的随访,并有可能获得更好的生活质量(注册编号808)。

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