Stents and surgical interventions in the palliation of gastric outlet obstruction: a systematic review

Show simple item record

dc.contributor Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP MINATA, Mauricio Kazuyoshi FMUSP-HC
BERNARDO, Wanderley Marques FMUSP-HC
ROCHA, Rodrigo Silva de Paula FMUSP-HC
MORITA, Flavio Hiroshi Ananias FMUSP-HC
AQUINO, Julio Cesar Martins FMUSP-HC
MOURA, Eduardo Guimaraes Hourneaux de FMUSP-HC 2016
dc.identifier.citation ENDOSCOPY INTERNATIONAL OPEN, v.4, n.11, p.E1158-E1170, 2016
dc.identifier.issn 2364-3722
dc.description.abstract Background and study aims: Palliative treatment of gastric outlet obstruction can be done with surgical or endoscopic techniques. This systematic review aims to compare surgery and covered and uncovered stent treatments for gastric outlet obstruction (GOO). Patients and methods: Randomized clinical trials were identified in MEDLINE, Embase, Cochrane, LILACs, BVS, SCOPUS and CINAHL databases. Comparison of covered and uncovered stents included: technical success, clinical success, complications, obstruction, migration, bleeding, perforation, stent fracture and reintervention. The outcomes used to compare surgery and stents were technical success, complications, and reintervention. Patency rate could not be included because of lack of uniformity of the extracted data. Results: Eight studies were selected, 3 comparing surgery and stents and 5 comparing covered and uncovered stents.The meta-analysis of surgical and endoscopic stent treatment showed no difference in the technical success and overall number of complications. Stents had higher reintervention rates than surgery (RD: 0.26, 95% CI [0.05, 0.47], NNH: 4). There is no significant difference in technical success, clinical success, complications, stent fractures, perforation, bleeding and the need for reintervention in the analyses of covered and uncovered stents. There is a higher migration rate in the covered stent therapy compared to uncovered self-expanding metallic stents (SEMS) in the palliation of malignant GOO (RD: 0.09, 95% CI [0.04, 0.14], NNH: 11). Nevertheless, covered stents had lower obstruction rates (RD: -0.21, 95% CI [-0.27,-0.15], NNT: 5). Conclusions: In the palliation of malignant GOO, covered SEMS had higher migration and lower obstruction rates when compared with uncovered stents. Surgery is associated with lower reintervention rates than stents.
dc.language.iso eng
dc.relation.ispartof Endoscopy International Open
dc.rights openAccess
dc.subject.other expandable metal stents; malignant gastroduodenal obstruction; randomized-trial; laparoscopic gastrojejunostomy; multicenter; metaanalysis; strictures; experience; cancer
dc.title Stents and surgical interventions in the palliation of gastric outlet obstruction: a systematic review
dc.type article
dc.rights.holder Copyright GEORG THIEME VERLAG KG LIM/35
dc.identifier.doi 10.1055/s-0042-115935
dc.identifier.pmid 27857965
dc.type.category review
dc.type.version publishedVersion MINATA, Mauricio Kazuyoshi:HC:ICHC BERNARDO, Wanderley Marques:FM: ROCHA, Rodrigo Silva de Paula:HC:ICHC MORITA, Flavio Hiroshi Ananias:HC:ICHC AQUINO, Julio Cesar Martins:HC:ICHC CHENG, Spencer:HC:ICHC ZILBERSTEIN, Bruno:FM:MGT SAKAI, Paulo:FM:MGT MOURA, Eduardo Guimaraes Hourneaux de:HC:ICHC WOS:000388642000007 STUTTGART GERMANY
hcfmusp.relation.reference · Adler DG, 2002, AM J GASTROENTEROL, V97, P72
· Chopita Nestor, 2007, Gastrointest Endosc Clin N Am, V17, P533, DOI 10.1016/j.giec.2007.05.007
· Costamagna G, 2012, DIGEST LIVER DIS, V44, P37, DOI 10.1016/j.dld.2011.08.012
· Dormann A, 2004, ENDOSCOPY, V36, P543, DOI 10.1055/s-2004-814434
· Fiori E, 2004, ANTICANCER RES, V24, P269
· Fiori E, 2013, AM J SURG, V206, P210, DOI 10.1016/j.amjsurg.2012.08.018
· Hosono S, 2007, J GASTROENTEROL, V42, P283, DOI 10.1007/s00535-006-2003-y
· Moura EGH, 2012, WORLD J GASTROENTERO, V18, P938, DOI 10.3748/wjg.v18.i9.938
· Jaka H, 2013, BMC SURG, V13, DOI 10.1186/1471-2482-13-41
· Jeurnink SM, 2010, J GASTROENTEROL, V45, P537, DOI 10.1007/s00535-009-0181-0
· Jeurnink SM, 2007, BMC GASTROENTEROL, V7, DOI 10.1186/1471-230X-7-18
· Jeurnink SM, 2011, DIGEST LIVER DIS, V43, P548, DOI 10.1016/j.dld.2011.01.017
· Jeurnink SM, 2010, GASTROINTEST ENDOSC, V71, P490, DOI 10.1016/j.gie.2009.09.042
· Kaw M, 2003, SURG ENDOSC, V17, P646, DOI 10.1007/s00464-002-8527-1
· Keranen I, 2010, SURG ENDOSC, V24, P891, DOI 10.1007/s00464-009-0686-x
· Kim CG, 2010, GASTROINTEST ENDOSC, V72, P25, DOI 10.1016/j.gie.2010.01.039
· Lee H, 2015, AM J GASTROENTEROL, V110, P1440, DOI 10.1038/ajg.2015.286
· Liberati A, 2009, PLOS MED, V6, DOI [10.1016/j.jclinepi.2009.06.006, 10.1371/journal.pmed.1000100]
· Lim SG, 2014, DIGEST LIVER DIS, V46, P603, DOI 10.1016/j.dld.2014.02.024
· Lo N N, 1991, Ann Acad Med Singapore, V20, P356
· Lopes CV, 2008, J CLIN GASTROENTEROL, V42, P991, DOI 10.1097/MCG.0b013e31815b0d81
· Ly J, 2010, SURG ENDOSC, V24, P290, DOI 10.1007/s00464-009-0577-1
· Maetani I, 2014, DIGEST ENDOSC, V26, P192, DOI 10.1111/den.12117
· Mehta S, 2006, SURG ENDOSC, V20, P239, DOI 10.1007/s00464-005-0130-9
· Nagaraja Vinayak, 2014, J Gastrointest Oncol, V5, P92, DOI 10.3978/j.issn.2078-6891.2014.016
· Pan YM, 2014, BMC GASTROENTEROL, V14, DOI 10.1186/1471-230X-14-170
· Park CI, 2013, DIGEST LIVER DIS, V45, P33, DOI 10.1016/j.dld.2012.08.021
· Shi D, 2014, GASTROENT RES PRACT, V2014
· Tringali A, 2014, GASTROINTEST ENDOSC, V79, P66, DOI 10.1016/j.gie.2013.06.032
· van Halsema EE, 2015, WORLD J GASTROENTERO, V21, P12468, DOI 10.3748/wjg.v21.i43.12468
· WEAVER DW, 1987, SURGERY, V102, P608
· Yang ZP, 2013, INT J MED SCI, V10, P825, DOI 10.7150/ijms.5969
· Zhang LP, 2011, JSLS-J SOC LAPAROEND, V15, P169, DOI 10.4293/108680811X13022985132074
· Zheng BB, 2012, DIGEST ENDOSC, V24, P71, DOI 10.1111/j.1443-1661.2011.01186.x
dc.description.index PubMed
dc.identifier.eissn 2196-9736

Files in this item

This item appears in the following Collection(s)

Show simple item record

Search DSpace


My Account