[Treatment Strategies for Gastric Cancer Patients with Gastric Outlet Obstruction].

Hyun Lim
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Abstract

Gastric cancer frequently leads to gastric outlet obstruction (GOO), causing significant symptoms and complications. Surgical bypass and stenting are two representative palliative treatments for GOO by gastric cancer. This study reviews clinical guidelines for malignant GOO treatment, highlighting differences in recommendations based on patient survival expectations and systemic health. A meta-analysis of surgical bypass and stenting in gastric cancer patients revealed no significant difference in technical and clinical success rates between the two treatments. However, stenting allowed faster resumption of oral intake and shorter hospital stays but had higher rates of major complications and reobstruction. Despite these differences, overall survival did not significantly differ between the two groups. Emerging techniques like EUS-guided gastrojejunostomy show promise but require further research and experienced practitioners. Ultimately, treatment should be tailored to patient preferences and the specific benefits and drawbacks of each method to improve quality of life and outcomes.

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[胃癌患者胃出口梗阻的治疗策略]。
胃癌经常导致胃出口梗阻(GOO),引起严重的症状和并发症。手术分流和支架植入是胃癌导致的胃出口梗阻的两种代表性姑息治疗方法。本研究回顾了恶性胃出口梗阻治疗的临床指南,强调了基于患者生存预期和全身健康状况的建议差异。一项关于胃癌患者手术分流术和支架植入术的荟萃分析显示,这两种治疗方法在技术和临床成功率上没有显著差异。然而,支架植入术能更快地恢复口服,住院时间更短,但主要并发症和再梗阻的发生率更高。尽管存在这些差异,但两组患者的总体存活率并无明显差别。EUS 引导下的胃空肠吻合术等新兴技术前景广阔,但需要进一步的研究和经验丰富的从业人员。最终,治疗应根据患者的偏好和每种方法的具体利弊进行调整,以提高生活质量和治疗效果。
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