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无法切除的癌症和胃出口梗阻患者的姑息性胃空肠吻合术:一项回顾性队列研究。

Palliative gastrojejunostomy in unresectable cancer and gastric outlet obstruction: a retrospective cohort study.

机构信息

Department of Surgery, Faculty of Medicine, Pontifical Catholic University of Chile, Santiago, Chile.

Department of Medical Education, Faculty of Medicine, Pontifical Catholic University of Chile, Santiago, Chile.

出版信息

Ann R Coll Surg Engl. 2021 Mar;103(3):197-202. doi: 10.1308/rcsann.2020.7016.

Abstract

INTRODUCTION

Palliative gastrojejunostomy is a surgical technique that allows restoration of oral intake among patients with gastric outlet obstruction (GOO) caused by unresectable neoplasms. Research suggests standard treatment for malignant GOO should be laparoscopic gastrojejunostomy (LGJ). This study presents the clinical outcomes of palliative gastrojejunostomy and compares results from LGJ and open gastrojejunostomy (OGJ) at our centre.

METHODS

We performed a retrospective analysis on patients who underwent palliative gastrojejunostomy for GOO caused by unresectable neoplasms between 2008 and 2018. We included demographic variables, time to recover intestinal transit, time to recover oral intake, hospital stay, complications and global survival.

RESULTS

A total of 39 patients underwent palliative gastrojejunostomy (20 OGJ, 19 LGJ). Patients in the LGJ group recovered oral intake and intestinal transit faster than those in the OGJ group (3 vs 5 days, <0.05). There were no statistically significant differences in median operating time, hospital stay or postoperative complications between the two groups. No intraoperative complications occurred. The estimated global survival was 178 days, with no significant difference between the groups.

CONCLUSIONS

Palliative LGJ allows earlier restoration of oral intake and does not increase morbidity or mortality. Palliative LGJ should be considered the standard treatment for these patients.

摘要

介绍

姑息性胃空肠吻合术是一种手术技术,可使因无法切除的肿瘤引起的胃出口梗阻(GOO)患者恢复口服摄入。研究表明,恶性 GOO 的标准治疗应是腹腔镜胃空肠吻合术(LGJ)。本研究介绍了姑息性胃空肠吻合术的临床结果,并比较了我们中心 LGJ 和开腹胃空肠吻合术(OGJ)的结果。

方法

我们对 2008 年至 2018 年间因无法切除的肿瘤引起的 GOO 而行姑息性胃空肠吻合术的患者进行了回顾性分析。我们纳入了人口统计学变量、恢复肠道转运的时间、恢复口服摄入的时间、住院时间、并发症和总体生存率。

结果

共有 39 名患者接受了姑息性胃空肠吻合术(20 例 OGJ,19 例 LGJ)。LGJ 组患者恢复口服摄入和肠道转运的时间比 OGJ 组更快(3 天 vs 5 天,<0.05)。两组的中位手术时间、住院时间或术后并发症无统计学差异。术中无并发症发生。估计的总体生存率为 178 天,两组之间无显著差异。

结论

姑息性 LGJ 可更早恢复口服摄入,且不会增加发病率或死亡率。姑息性 LGJ 应被视为这些患者的标准治疗方法。

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