Enrico Fiori1, Antonio V Sterpetti2, Alesando De Cesare1, Antonietta Lamazza1. 1. Policlinico Umberto I, University of Rome Sapienza, Viale del Policlinico, 00167, Rome, Italy. 2. Policlinico Umberto I, University of Rome Sapienza, Viale del Policlinico, 00167, Rome, Italy. antonio.sterpetti@uniroma1.it.
Abstract
BACKGROUND: Controversies exist about the optimal palliative management for patients with metastatic antropyloric adenocarcinoma. The aim of this study was to analyse the clinical outcome for patients with gastric outlet obstruction syndrome and metastatic antropyloric adenocarcinoma, who underwentendoscopic stenting or open gastrojejunostomy, in a prospective not randomised study. MATERIAL: The clinical course and costs for 70 patients who had endoscopic stenting and for 30 patients who had in the same period a gastrojejunostomy for gastric outlet obstruction syndrome due to metastatic adenocarcinoma of the antropyloric region were prospectively analysed. RESULTS:Hospital stay and time to resume oral feeding was shorter in patients who had endoscopic stenting (p < 0.05). Overall costs for endoscopic stenting were lower than those for gastrojejunostomy (11,000 versus 21,000 euros). Comparing patients who survived more than 6 months, costs between endoscopic stenting and gastrojejunostomy were similar (21,000 versus 22,000 euros). CONCLUSIONS:Endoscopic placement of metallic stents offers an effective therapy in patients with advanced primay adenocarcinoma of the antropyloric region and poor general conditions. In patients with longer life expectancy, surgical gastroenterostomy has still a major role. In contrast to previous reports, costs for endoscopic stenting are similar to those of gastrojejunostomy in patients with longer life expectancy. Laparoscopic gastrojejunostomy has the theoretical advantage to reduce these costs with a less invasive procedure. Results for endoscopic stenting have improved significantly in recent years.
RCT Entities:
BACKGROUND: Controversies exist about the optimal palliative management for patients with metastatic antropyloric adenocarcinoma. The aim of this study was to analyse the clinical outcome for patients with gastric outlet obstruction syndrome and metastatic antropyloric adenocarcinoma, who underwent endoscopic stenting or open gastrojejunostomy, in a prospective not randomised study. MATERIAL: The clinical course and costs for 70 patients who had endoscopic stenting and for 30 patients who had in the same period a gastrojejunostomy for gastric outlet obstruction syndrome due to metastatic adenocarcinoma of the antropyloric region were prospectively analysed. RESULTS: Hospital stay and time to resume oral feeding was shorter in patients who had endoscopic stenting (p < 0.05). Overall costs for endoscopic stenting were lower than those for gastrojejunostomy (11,000 versus 21,000 euros). Comparing patients who survived more than 6 months, costs between endoscopic stenting and gastrojejunostomy were similar (21,000 versus 22,000 euros). CONCLUSIONS: Endoscopic placement of metallic stents offers an effective therapy in patients with advanced primay adenocarcinoma of the antropyloric region and poor general conditions. In patients with longer life expectancy, surgical gastroenterostomy has still a major role. In contrast to previous reports, costs for endoscopic stenting are similar to those of gastrojejunostomy in patients with longer life expectancy. Laparoscopic gastrojejunostomy has the theoretical advantage to reduce these costs with a less invasive procedure. Results for endoscopic stenting have improved significantly in recent years.
Authors: Chan Gyoo Kim; Il Ju Choi; Jong Yeul Lee; Soo-Jeong Cho; Sook Ryun Park; Jun Ho Lee; Keun Won Ryu; Young-Woo Kim; Young Iee Park Journal: Gastrointest Endosc Date: 2010-04-09 Impact factor: 9.427
Authors: Suzanne M Jeurnink; Casper H J van Eijck; Ewout W Steyerberg; Ernst J Kuipers; Peter D Siersema Journal: BMC Gastroenterol Date: 2007-06-08 Impact factor: 3.067
Authors: Rajesh Krishnamoorthi; Shivanand Bomman; Petros Benias; Richard A Kozarek; Joyce A Peetermans; Edmund McMullen; Ornela Gjata; Shayan S Irani Journal: Endosc Int Open Date: 2022-06-10