Surgical Palliation for Gastric Outlet Obstruction

Among patients with malignant gastric outlet obstruction caused by gastric cancer, surgical palliation was effective for maintaining patient quality of life and improving the ability to ingest solid foods, according to a paper being presented at the 2017 American Society of Clinical Oncology Gastrointestinal Symposium.¹

Surgical palliation can have mixed consequences for a patient’s quality of life. For this prospective, multicenter study, researchers enrolled 104 patients to determine the effects on quality of life produced by surgical palliation. Patients qualified only if solids could not be ingested orally.

Twenty-three patients underwent distal gastrectomy, 9 underwent total gastrectomy, 70 underwent gastrojejunostomy, and 2 underwent exploratory laparotomy. Each patient’s physician chose the surgical operation.

Results were obtained via questionnaire, and were completed at baseline and at 2 weeks, 1 month, and 3 months post-surgery. The observational outcomes were improvement of oral intake and safety.

After 3 months, 75 patients were able to ingest solid foods orally; this was a decrease from 82 patients at 2 weeks post-surgery.

Ten patients had grade 3 or worse morbidity; 2 patients died within 30 days of surgery.

The authors concluded that surgical palliation is acceptably safe and improves quality of life in this patient population.

Reference

1. Fujitani K, Ando M, Sakamaki K, et al. A prospective multicenter observational study of surgical palliation examining postoperative quality of life in patients treated for malignant gastric outlet obstruction caused by incurable advanced gastric cancer. J Clin Oncol. 2017;35(suppl):4S. Abstract 6.