Experience in the management of neoplastic gastric outlet obstruction in patients at the Hospital Universitario San Ignacio in Bogotá, Colombia

A F Ovalle-Hernández; R D Vargas-Rubio

doi:10.1016/j.rgmx.2020.09.006

Experience in the management of neoplastic gastric outlet obstruction in patients at the Hospital Universitario San Ignacio in Bogotá, Colombia

Rev Gastroenterol Mex (Engl Ed). 2020 Dec 31:S0375-0906(20)30136-1. doi: 10.1016/j.rgmx.2020.09.006. Online ahead of print.

[Article in English, Spanish]

Authors

A F Ovalle-Hernández¹, R D Vargas-Rubio²

Affiliations

¹ Unidad de Gastroenterología, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá D.C., Colombia. Electronic address: afovalle@javeriana.edu.co.
² Unidad de Gastroenterología, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá D.C., Colombia.

PMID: 33390275
DOI: 10.1016/j.rgmx.2020.09.006

Abstract

Introduction: Malignant gastric outlet obstruction is a condition that alters patient quality of life, conditioning progressive malnutrition. However, self-expanding metal stents (SEMSs) and surgical gastrojejunostomy (SGJ) are palliative options in patients with unresectable disease.

Aims: To characterize patients diagnosed with malignant gastric outlet obstruction requiring SEMS placement or SGJ.

Materials and methods: Sequential non-probability convenience sampling was conducted and included 68 patients, 40 of whom had SEMS placement and 28 of whom underwent SGJ.

Results: Patients sought medical consultations for the symptoms of vomiting, abdominal pain, weight loss, and upper gastrointestinal bleeding. Ninety-five percent of the patients in the SEMS group and 64.3% in the SGJ group presented with metastasis. Technical and clinical success, patency duration, and number of patients with no complications were greater in the SGJ group. Mean survival in days was 88 (SD ± 21) in the SEMS group versus 501 (SD ± 122) in the SGJ group. The log-rank test detected a statistically significant difference between subgroups (p = 0.00).

Conclusion: SGJ has greater technical and clinical success rates but SEMS placement continues to be utilized in distal gastric cancer, especially in cases in which surgery is not an option.

Keywords: Cáncer gástrico distal; Distal gastric cancer; Gastrojejunostomy; Gastroyeyunostomía; Malignant obstruction; Obstrucción maligna; Self-expanding stent; Stent metálico autoexpandible.