[Gastrojejunostomy versus endoscopic stent placement as palliative treatment for a malignant constriction of the duodenum: the SUSTENT-study].
Gastric-outlet obstruction often results from inoperable distal stomach, periampullary (pancreatic or cholangio-), or duodenal carcinoma. Gastrojejunostomy and stent placement are standard palliative treatments. An advantage of gastrojejunostomy is the long-term efficacy; a disadvantage is the prolonged postoperative recovery time. The advantage of stent placement is the rapid ability to consume a soft diet; a disadvantage is that around 20% of the patients require re-intervention because of recurrent symptoms. A randomised multicentre study was started in January 2006 in the Netherlands in which gastrojejunostomy is compared with stent placement in the palliative treatment of malignant gastroduodenal obstruction: 'Surgery versus stent for malignant gastroduodenal obstruction', the SUSTENT-study. The primary-outcome measurement is survival adjusted for the time patients are not able to consume (soft) food. Other outcome measurements are medical effects (complications, re-interventions), quality of life, cost and cost-effectiveness. This study aims to provide individualised recommendations for effective palliative treatment of patients with malignant gastroduodenal obstruction.
Jeurnink
S M
SM
Erasmus MC-Centrum, Postbus 2040, kamer Hs-512, 3000, CA Rotterdam.
Steyerberg
E W
EW
van Eijck
C H J
CH
Kuipers
E J
EJ
Siersema
P D
PD
D004067:Digestive System Neoplasms / Q000150:complications; D013505:Digestive System Surgical Procedures / Q000379:methods; D004380:Duodenal Obstruction / Q000209:etiology / Q000601:surgery*; D017219:Gastric Outlet Obstruction / Q000209:etiology / Q000601:surgery*; D005774:Gastrostomy; D006801:Humans; D007582:Jejunostomy; D010166:Palliative Care / Q000379:methods; D015607:Stents; D016896:Treatment Outcome