The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
Emergency Medical Center, Ningbo Yinzhou No. 2 Hospital, Ningbo, Zhejiang, China.
Am J Surg. 2022 Jun;223(6):1067-1078. doi: 10.1016/j.amjsurg.2021.10.038. Epub 2021 Oct 30.
This study aimed to determine the optimal intervention modality for malignant GOO by comparing clinical outcomes after Gastrojejunostomy and endoscopic stenting.
Two authors independently searched Web of Science, PubMed, Embase, and the Cochrane Library for articles before February 2021 to compare the clinical outcomes of GOO patients undergoing GJ or ES.
This meta-analysis included 31 articles with 2444 GOO patients. Although the GJ group outperformed the ES group in technical success (OR,3.79; P = 0.003), clinical success was not significantly different between the two groups (OR,1.25; P = 0.50). The GJ group had a longer hospitalization, lower re-obstruction and lower reintervention. Moreover, GJ had a better survival than ES in the gastric cancer group (HR, 0.33; P = 0.009). However, no significant statistical difference was observed in the pancreatic cancer group (HR, 0.55; P = 0.159).
Both GJ and ES are safe and effective intervention modalities for malignant GOO. GJ had significantly improved survival in gastric cancer patients with GOO, while no significant difference was observed between the two groups in pancreatic cancer patients with GOO.
本研究旨在通过比较胃空肠吻合术和内镜支架置入术治疗恶性 GOO 的临床结局，来确定恶性 GOO 的最佳干预方式。
两位作者独立检索了 Web of Science、PubMed、Embase 和 Cochrane Library 截至 2021 年 2 月的文献，以比较接受 GJ 或 ES 的 GOO 患者的临床结局。
这项荟萃分析纳入了 31 篇文章，共计 2444 例 GOO 患者。尽管 GJ 组在技术成功率方面优于 ES 组（OR，3.79；P=0.003），但两组在临床成功率方面无显著差异（OR，1.25；P=0.50）。GJ 组的住院时间更长，再梗阻和再介入率更低。此外，在胃癌组中，GJ 的生存状况优于 ES（HR，0.33；P=0.009）。然而，在胰腺癌组中，未观察到显著的统计学差异（HR，0.55；P=0.159）。
GJ 和 ES 均是恶性 GOO 的安全有效的干预方式。GJ 可显著改善胃癌合并 GOO 患者的生存状况，而在胰腺癌合并 GOO 患者中，两组之间无显著差异。
