[Investigation of Preoperative Chemotherapy Using Enterostomy for Advanced Gastric Cancer with Stenosis].

Background: Preoperative chemotherapy for gastric cancer with obstructive symptoms traditionally requires bypass surgery.

Objective: To investigate the feasibility of preoperative enterostomy chemotherapy in patients with advanced gastric cancer who present with obstructive symptoms.

Methods: A total of 47 patients with cStage Ⅲ gastric cancer who underwent preoperative chemotherapy between April 2013 and May 2024 were included. Patients with circumferential lesions underwent enterostomy during diagnostic laparoscopy, which was followed by chemotherapy.

Results: The enterostomy and non-enterostomy groups included 20 and 27 patients, respectively. The chemotherapy regimens included SOX, SOX+nivolumab, SP, biweekly NAC-DCS, and XP+trastuzumab. Grade 3 or higher adverse events, including neutropenia, malaise, and diarrhea, were more common in the no-enterostomy group. The completion rates of at least 2 chemotherapy courses were similar between groups. Grade Ⅲa or higher complications during gastrectomy were slightly higher in the enterostomy group. The pathological responses were comparable between groups.

Conclusion: Preoperative chemotherapy using enterostomy for advanced gastric cancer with obstructive symptoms showed efficacy and safety comparable to those of traditional methods, suggesting that it is a viable treatment option.