RESUMO
BACKGROUND: In this retrospective study, we investigated the clinical outcomes of endoscopic gastroduodenal stenting (EGDS) for gastric outlet obstruction( GOO) caused by unresectable gastric cancer( UGC). METHODS: A retrospective study was performed on 20 UGC patients with GOO between 2007 and 2012. We compared the clinical outcomes of EGDS using the WallFlex stent( GDS group, n=8) and palliative Roux-en-Y gastrojejunostomy( RYGJ group, n=12). RESULTS: The numbers of patients with a poor performance status and prior use of chemotherapy were higher in the GDS group than in the RYGJ group. No postoperative complications were observed, and the GOO score improved in both groups. The median days taken to resume oral food intake, the median duration of oral food intake, and the median survival time in the RYGJ and GDS groups were 4 and 3 days( p=0.0008), 301 and 151 days( p=0.0698), and 345 and 161 days (p=0.0070), respectively. CONCLUSIONS: EGDS for GOO caused by UGC can be performed safely even after chemotherapy and is beneficial in terms of improvement of oral food intake.
Assuntos
Duodeno , Obstrução da Saída Gástrica/terapia , Stents , Neoplasias Gástricas/complicações , Idoso , Idoso de 80 Anos ou mais , Endoscopia Gastrointestinal , Feminino , Derivação Gástrica/efeitos adversos , Obstrução da Saída Gástrica/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Stents/efeitos adversos , Resultado do TratamentoRESUMO
The simplified international diagnostic criteria for autoimmune hepatitis (AIH), re-revised by the International AIH Group in 2008, were investigated in 114 patients with AIH from 15 centers in Japan. While applying of the criteria, we had to pay attention to anti-nuclear antibody measurement methods, and liver histology scoring. Definite and probable AIH were diagnosed in 83 and 22 patients, respectively. The criteria were found to be useful for the diagnosis of AIH in Japan. However, 9 patients who did not meet the diagnostic criteria showed normal immunoglobulin G levels or were negative for autoantibodies. As the criteria were unreliable for diagnosing such atypical cases in the present series, we speculated that we should not rely solely on these, criteria and take a more holistic approach to diagnosis in such cases.
Assuntos
Hepatite Autoimune/diagnóstico , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
BACKGROUND: The standard therapy for gastric cancer with peritoneal metastasis has remained unclear. PURPOSE: This prospective feasibility study was aimed to investigate the efficacy and safety of S-1 plus paclitaxel for advanced/recurrent gastric cancer patients with peritoneal metastasis able to take oral feeding. PATIENTS AND METHODS: Seven patients were enrolled in this study. Paclitaxel 50mg/m2 was administered on days 1 and 8. S-1 was administered orally at 40 mg/m2 bid for 14 consecutive days, followed by a 1-week rest. Overall survival, the response rate and safety were examined for efficacy and tolerability. RESULTS: The median survival time was 310 days. The response rate in five patients was 80. 0%. Grade 3 toxicity was observed in two patients. Combination chemotherapy of weekly paclitaxel and S-1 demonstrated efficacy and tolerable toxicity. This regimen will be one of the initial treatment options for unresectable or metastatic gastric cancer with peritoneal metastasis.
