[A prospective comparative study of three treatment options in patients with malignant gastric outlet obstruction].
OBJECTIVE
To evaluate outcomes after different treatment options including endoscopic stent placement, surgical bypass, and percutaneous gastrostomy for malignant gastric outlet obstruction (GOO).


METHODS
Thirty-nine patients with GOO secondary to unresectable primary or metastatic cancer were treated with endoscopic stent placement (group 1, n=13), surgical bypass (group 2, n=21), or percutaneous gastrostomy (group 3, n=5). QLQ-STO22 form was used to assess quality of life (QOL) at baseline, 1 month, and 3 months following intervention.


RESULTS
Overall median survival time was 68 days. Median survival time in group 1 and group 2 was 85 and 72 days respectively, longer than that in group 3 (48 days, P<0.05). Fourteen patients (7 cases in group 1 and 7 cases in group 2) completed all three QOL surveys. All the patients in group 1 had significant improvement in dysphagia, dietary restrictions, dry mouth, and reflux (P<0.05). In group 2, dysphagia and dietary restrictions were significantly improved (P<0.05), while there were no significant improvements in dry mouth, reflux and pain (all P>0.05).


CONCLUSIONS
Although the prognosis of malignant GOO is poor, endoscopic stent placement and surgical bypass may improve QOL of patients and therefore are reasonable alternatives for palliation.
Guo
Jing-jin
JJ
Department of General Surgery, Panyu Center Hospital of Guangzhou, Guangzhou 511400, China. guojingjinsu@163.com
Liang
Wei-xiong
WX
Zhang
Tong
T
D000368:Aged; D005260:Female; D017219:Gastric Outlet Obstruction / Q000209:etiology / Q000601:surgery*; D005774:Gastrostomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D015607:Stents; D013274:Stomach Neoplasms / Q000150:complications / Q000601:surgery*