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Advanced gastric cancer with pyloric obstruction is usually identified as surgical indication. For these patients,direct surgical treatment may lose opportunity for effective reduction and radical resection.This paper reported one case of gastric cancer with pyloric obstruction treated by neoadjuvant chemotherapy and nutritional support.The treatment methods were retrospectively analyzed. Combined with related literature, the clinical characteristics and treatment options were analyzed.
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A case of toxaemia secondary to pyloric foreign body obstruction in two four-month-old African lion cubs were presented in this article. The lion cubs were presented to the school of veterinary medicine with a complaint of weight loss and stunted growth despite having a normal appetite and seizures. Definitive diagnosis was made based on gross pathology after attempting various symptomatic treatments. This article therefore is meant to discourage the use of blankets as bedding in holding enclosures for warmth and comfort post-weaning in captive lion cubs and indeed wild cats in general as they tend to eat bedding that has been soiled with food.
ABSTRACT
A case of toxaemia secondary to pyloric foreign body obstruction in two four-month-old African lion cubs were presented in this article. The lion cubs were presented to the school of veterinary medicine with a complaint of weight loss and stunted growth despite having a normal appetite and seizures. Definitive diagnosis was made based on gross pathology after attempting various symptomatic treatments. This article therefore is meant to discourage the use of blankets as bedding in holding enclosures for warmth and comfort post-weaning in captive lion cubs and indeed wild cats in general as they tend to eat bedding that has been soiled with food.
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Objective To compare surgical gastrojejunostomy and endoscopic stenting in palliation of malignant gastric outlet obstruction.Methods This retrospective study investigated patients treated for malignant gastric outlet obstruction from January 2007 to January 2014 in the first affiliated hospital of Nanjing Medical University.Endoscopic stenting was placed in 29 patients and surgical gastrojejunostomy was performed in 42 patients.The outcomes assessed included diet scores,time to diet,length of hospital stay,treatments fees and complications.Results Both endoscopic stenting and surgical gastrojejunostomy can relieve patients' syndrome with significant higher GOOSS score compared with that before treatment (P ＜0.05),but score improves faster in stenting group.Clinical success for endoscopic stenting and surgical gastrojejunostomy was 96.6％ and 92.9％ respectively,and technical success was 100％ for both of them.Endoscopic stenting group was found to have lower early complication rate(3.4％ VS 23.8％,P ＜0.05),higher late complication rate(24.1％ VS 6.9％,P ＜0.05),less time to diet,hospital stay and treatment fees(all P value ＜ 0.05)than surgical gastrojejunostomy group.The major complication after endoscopic stenting is re-obstruction while it is infection and leak of anastomotic site for surgical group.There were no significant differences in complication between two groups (27.6％ VS 11.9％,P ＞ 0.05).Conclusion Both endoscopic stenting and surgical gastrojejunostomy can relieve patients' syndrome effectively and safely,but endoscopic stenting improves GOOSS scores more rapid with less time to diet,less early complication rate and easy-dealing late complications,also it needs less hospital stay and fees.It's a better choice for patients with less survival expectation.
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PURPOSE: In gastric cancer patients with gastric outlet obstruction, there are several complications such as malnutrition and vomiting. Palliative enteral stenting is a less invasive procedure as compared with a gastrojejunostomy. The aim of this study was to determine whether there was a significant difference between patients that undergone palliative enteral stenting and patients that had received a bypass gastrojejunostomy. MATERIALS AND METHODS: One hundred patients underwent palliative entering stenting and 31 patients were subjected to a surgical bypass gastrojejunostomy. We reviewed the medical records of the patients with gastric outlet obstruction secondary to far advanced gastric cancer that were diagnosed using a gastrofibroscope, UGI and abdominal CT, and were admitted to our institution between January 2000 and August 2006. The outcome of stent placement for gastric outlet obstruction was compared with palliative gastrojejunostomy during the same period. We excluded patients with recurrent gastric cancer and double cancer from this study. RESULTS: There were significant differences between the group of patients that underwent stenting and the group of patients that received a gastrojejunostomy regarding the age of patients (67+/-12 vs. 57+/-9, P<0.001) but not between the sex of the patients (M : F, 2 : 1 vs. 2 : 1, P=0.637). The most common complication of stenting was tumor ingrowth (16/100, 16%) and the second most common complication was stent migration (14/100). Failure of the procedure occurred in only three patients. Twenty-three patients underwent re-stenting and one patient required open conversion with a gastrojejunostomy. The median time to the first meal was 4+/-2 days in the stent group of patients and 6+/-2 days in the gastrojejunostomy group of patients (P=0.001). The median postoperative hospital stays were 9 days in the stent group of patients and 15 days in the gastrojejunostomy group of patients (P=0.003). The mean survival periods were 11 months in the stent group of patients and 10 months in the gastrojejunostomy group of patients (P=0.937). CONCLUSION: There were no significant differences in the mean survival rates. An earlier first meal and a shorter hospitalization stay were found in the stenting group of patients compared to the bypass gastrojejunostomy group of patients. However, re-stenting was a concern due to tumor ingrowth and stent migration.
Subject(s)
Humans , Gastric Bypass , Gastric Outlet Obstruction , Hospitalization , Length of Stay , Malnutrition , Meals , Medical Records , Stents , Stomach Neoplasms , Survival Rate , Tomography, X-Ray Computed , VomitingABSTRACT
Objective To search the surgical methods of esophageal carcinoma complicated with cicatricial pyloric obstruction .Methods 18 cases were treated with resection. Among the resections,16 cases underwent resection of esophageal carcinoma esophago-gastrostomy above aortic arch in chest plus gastro-jejunum anastomosis ;2 cases treatment with resection of esophageal carcinoma plus esophago-gastretomy above aortic arch in chest combined with pyloroplasty.Results Of 18 cases ,cure rate was 100%.No severe complications were occurred in the procedure. Conclusion Surgical operation is safe , applicable and effective in treatment of esophageal carcinoma complicated with cicatricial pyloric obstruction.
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Placement of the self-expandable metallic stents for palliative treatment of malignant esophagogastric strictures has been thought to be easy, fast and effective method than conventional methods (bypass procedures, radiation therapy, laser treatment, esophageal intubation, etc.). The expandable metallic stent tubes were found to overcome some of the limitations of nonexpandable conventional tubes. Their implantation is better tolerated and safer than that of nonexpandable tubes, because the risks of migration and perforation are lower.On our knowledge, there has been no report of pyloric obstruction after this metallic stent insertion.We hereby report a case of pyloric obstruction caused by a migrated self-expandable metallic stent for palliative treatment of malignant esophageal stricture.