PMID- 33043118
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201013
IS  - 2364-3722 (Print)
IS  - 2196-9736 (Electronic)
IS  - 2196-9736 (Linking)
VI  - 8
IP  - 10
DP  - 2020 Oct
TI  - Palliative treatment for malignant gastrointestinal obstruction with peritoneal 
      carcinomatosis: enteral stenting versus surgery.
PG  - E1487-E1494
LID - 10.1055/a-1237-3956 [doi]
AB  - Background and study aims  Management of malignant gastrointestinal obstruction 
      (MGIO) is more challenging in the presence of peritoneal carcinomatosis (PC). 
      Outcomes data to guide the management of MGIO with PC are lacking. We aimed to 
      compare the clinical outcomes and adverse events between endoscopic and surgical 
      palliation and identify predictors of stent success in patients with MGIO with 
      PC. Patients and methods  Consecutive inpatients with MGIO with PC between 2000 
      and 2018 who underwent palliative surgery or enteral stenting were included. 
      Clinical success was defined as relief of obstructive symptoms. Results  
      Fifty-seven patients with enteral stenting and 40 with palliative surgery were 
      compared. The two groups did not differ in rates of technical success, 30-day 
      mortality, or recurrence. Clinical success from a single intervention (63.2 % 
      versus 95 %), luminal patency duration (27 days vs. 145 days), and survival 
      length (148 days vs. 336 days) favored palliative surgery (all P  < 0.05) but the 
      patients in the surgery group had a trend toward better Eastern Cooperative 
      Oncology Group (ECOG) status. The rate of adverse events (AEs) (10.5 % vs. 50 %), 
      the severity of AEs, and length of hospital stay (4.5 days vs. 9 days) favored 
      enteral stenting ( P  < 0.05). The need for more than one stent was associated 
      with a higher likelihood of stent failure. Conclusions  Our study suggests that 
      enteral stenting is safer and associated with a shorter hospital stay than 
      palliative surgery, although unlike other MGIOs, clinical success is lower in 
      MGIO with PC. Identification of the right candidates and potential predictors of 
      clinical success in ECOG-matched large-scale studies is needed to validate these 
      results.
CI  - The Author(s). This is an open access article published by Thieme under the terms 
      of the Creative Commons Attribution-NonDerivative-NonCommercial License, 
      permitting copying and reproduction so long as the original work is given 
      appropriate credit. Contents may not be used for commecial purposes, or adapted, 
      remixed, transformed or built upon. 
      (https://creativecommons.org/licenses/by-nc-nd/4.0/).
FAU - Jaruvongvanich, Veeravich
AU  - Jaruvongvanich V
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, 
      United States.
FAU - Chesta, Fnu
AU  - Chesta F
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, 
      United States.
FAU - Baruah, Anushka
AU  - Baruah A
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, 
      United States.
FAU - Oberoi, Meher
AU  - Oberoi M
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, 
      United States.
FAU - Adamo, Daniel
AU  - Adamo D
AD  - Division of Radiology, Mayo Clinic, Rochester, Minnesota, United States.
FAU - Singh, Prabh G
AU  - Singh PG
AD  - Government Medical College and Hospital, Chandigarh, India.
FAU - Meyer, Alyssa
AU  - Meyer A
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, 
      United States.
FAU - Law, Ryan J
AU  - Law RJ
AD  - University of Michigan, Gastroenterology and Hepatology, Ann Arbor, Michigan, 
      United States.
FAU - Buttar, Navtej
AU  - Buttar N
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, 
      United States.
LA  - eng
PT  - Journal Article
DEP - 20201007
PL  - Germany
TA  - Endosc Int Open
JT  - Endoscopy international open
JID - 101639919
PMC - PMC7541184
COIS- Competing interests Dr. Buttar is a consultant of Medrobotics and Ovesco. Dr. Law 
      is a consultant of Olympus, America
EDAT- 2020/10/13 06:00
MHDA- 2020/10/13 06:01
PMCR- 2020/10/01
CRDT- 2020/10/12 05:33
PHST- 2020/02/17 00:00 [received]
PHST- 2020/07/07 00:00 [accepted]
PHST- 2020/10/12 05:33 [entrez]
PHST- 2020/10/13 06:00 [pubmed]
PHST- 2020/10/13 06:01 [medline]
PHST- 2020/10/01 00:00 [pmc-release]
AID - 10.1055/a-1237-3956 [doi]
PST - ppublish
SO  - Endosc Int Open. 2020 Oct;8(10):E1487-E1494. doi: 10.1055/a-1237-3956. Epub 2020 
      Oct 7.