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A Meta-Analysis of Endoscopic Stenting Versus Surgical Treatment for Malignant Gastric Outlet Obstruction

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Abstract

Background and Aim

Surgical gastrojejunostomy (GJJ) and endoscopic stenting (ES) are the two most available treatments for palliation of malignant gastric obstruction (MGOO). The aim of this study is to compare these two techniques regarding efficacy, safety, time of hospitalization and survival.

Methods

We performed a literature search from January 2010 to September 2020 to identify available randomized controlled studies and observational studies that compared ES and GJJ for the treatment of MGOO.

Results

A total of 17 studies were found. ES and GJJ showed similar technical and clinical success rate. ES was superior to obtain early oral re-feeding, shorter length of hospitalization and a lower incidence of complications than GJJ. Surgical palliation had a lower recurrence rate of obstructive symptoms and longer overall survival than ES.

Conclusions

Both procedures have advantages and disadvantages. Probably we should not find the best palliation but the best approach based on the patient characteristics and tumor type.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.

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Authors and Affiliations

  1. Gastroenterology Department, Santa Corona Hospital, ASL 2 Savonese, Viale 25 Aprile, 38, 17027, Pietra Ligure, SV, Italy

    Lorenzo Del Nero, Afscin Djahandideh Sheijani, Peter Siersema & Massimo Conio

  2. Gastroenterology Department, Sanremo General Hospital, ASL1 Imperiese, Sanremo, IM, Italy

    Antonella De Ceglie & Peter Siersema

  3. Clinical Epidemiology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy

    Marco Bruzzone, Marcello Ceppi, Rosa Angela Filiberti & Peter Siersema

  4. Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, Netherlands

    Peter Siersema

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Correspondence to Lorenzo Del Nero.

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Del Nero, L., Sheijani, A.D., De Ceglie, A. et al. A Meta-Analysis of Endoscopic Stenting Versus Surgical Treatment for Malignant Gastric Outlet Obstruction. World J Surg 47, 1519–1529 (2023). https://doi.org/10.1007/s00268-023-06944-3

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