腹腔镜胃空肠吻合术与内窥镜支架植入术作为胃出口梗阻的姑息治疗方法。

IF 1.1 4区 医学 Q3 SURGERY Journal of Laparoendoscopic & Advanced Surgical Techniques Pub Date : 2024-08-01 Epub Date: 2024-07-08 DOI:10.1089/lap.2024.0162
Avihai Moscovici, Yehuda Hershkovitz, Steven Shamah, Noam Peleg, Ron Lavy, Amir Ben-Yehuda
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引用次数: 0

摘要

简介胃出口梗阻(GOO)是上消化道恶性肿瘤晚期常见的并发症。严重恶心和长期呕吐的症状可导致生活质量下降和恶病质。胃食管返流的症状可通过手术或非手术姑息性干预得到有效控制。在本文中,我们旨在比较腹腔镜胃空肠吻合术(GJ)和内窥镜支架植入术作为姑息性干预措施对 GOO 的治疗效果。方法:我们对接受胃出口梗阻姑息手术的患者病历进行了回顾性评估。第一组包括接受内镜支架植入术的患者,第二组患者接受腹腔镜 GJ 术。比较了两组患者的人口统计学特征(年龄、性别)、手术时间、住院时间、口服天数、总生存率、并发症发生率和 30 天死亡率。结果:研究共纳入 38 名患者。19名患者接受了内窥镜支架植入术,19名患者接受了腹腔镜GJ术。比较两组患者,未发现明显差异。手术时间明显长于内窥镜手术(83 分钟对 25 分钟,P = .001)。在开始口服的天数、总存活率和 30 天死亡率方面没有明显差异。支架植入组有五名患者出现并发症(26.3%),而手术组无并发症(P = .046)。术后未发现并发症。结论:腹腔镜 GJ腹腔镜 GJ 是治疗 GOO 的一种安全可行的方法,能尽早恢复口腔摄入。住院时间相对较短,术后并发症情况良好,再次干预率低,尤其是对于预期寿命较长的患者,应牢记这一点。
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Laparoscopic Gastrojejunostomy Versus Endoscopic Stenting as a Palliative Treatment for Gastric Outlet Obstruction.

Introduction: Gastric outlet obstruction (GOO) is a common complication in advanced stage upper gastrointestinal malignancies. The symptoms of severe nausea and protracted vomiting can lead to a decline in quality of life and cachexia. Symptoms of GOO can be effectively managed with either operative or nonoperative palliative interventions. In our article, we aim to compare laparoscopic gastrojejunostomy (GJ) to endoscopic stenting as palliative interventions for GOO. Methods: We retrospectively evaluated the charts of patients who underwent palliative procedure for gastric outlet obstruction. Group I included patients who underwent endoscopic stenting, and group II patients underwent Laparoscopic GJ. The groups' demographics (age, gender), length of procedure, length of stay, days to oral intake, overall survival, complications rate, and 30-day mortality rates were compared. Results: Overall, 38 patients were included in the study. Nineteen patients underwent endoscopic stenting and 19 underwent laparoscopic GJ. Comparing the groups, no significant differences were noted. Surgical time was significantly longer than the endoscopic procedures (83 minutes versus 25 minutes, P = .001). No significant differences were noted in days of oral intake initiation, overall survival and 30-day mortality rates. Five patients in the stenting group had complications (26.3%) versus none in the surgical group (P = .046). No postoperative complications were noted. Conclusion: Laparoscopic GJ is a safe and feasible treatment for GOO, demonstrating early resumption of oral intake. The relative short hospital stay, combined with an encouraging postoperative complications profile and low reintervention rate, should be kept in mind especially among patients with longer life expectancy.

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来源期刊
CiteScore
2.90
自引率
0.00%
发文量
163
审稿时长
3 months
期刊介绍: Journal of Laparoendoscopic & Advanced Surgical Techniques (JLAST) is the leading international peer-reviewed journal for practicing surgeons who want to keep up with the latest thinking and advanced surgical technologies in laparoscopy, endoscopy, NOTES, and robotics. The Journal is ideally suited to surgeons who are early adopters of new technology and techniques. Recognizing that many new technologies and techniques have significant overlap with several surgical specialties, JLAST is the first journal to focus on these topics both in general and pediatric surgery, and includes other surgical subspecialties such as: urology, gynecologic surgery, thoracic surgery, and more.
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