推进恶性胃出口梗阻的护理:当代管理策略回顾。

IF 2.5 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Current Opinion in Gastroenterology Pub Date : 2025-11-01 Epub Date: 2025-04-23 DOI:10.1097/MOG.0000000000001101
Adrianna Wierzbicka, Tilak Shah
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引用次数: 0

摘要

综述目的:本综述的目的是总结恶性胃出口梗阻(MGOO)治疗的最相关数据,并重点介绍最近的最新进展。传统上,恢复MGOO患者腔内通畅的选择是手术胃空肠造口术(SGJ)和内镜下置入肠内支架。后者用于表现不佳或预期生存期小于2个月的患者。内镜下胃肠造口术(EUS-GE)是一种较新的技术,旨在模拟SGJ,并将腔侧金属支架(LAMS)从胃直接置入空肠。在最近的一项EUS-GE与肠内支架的随机试验中,前者与减少再干预、改善支架通畅和改善患者报告的饮食习惯相关。最近的出版物表明,eu - ge可能比S-GJ具有实质性的优势;一项随机试验目前正在进行中。通气胃造口术可能是胃运动明显受损或有多重腔道阻塞的患者最合适的选择。摘要:MGOO是晚期上消化道恶性肿瘤的一种衰弱的晚期并发症,由远端胃、幽门窦或十二指肠阻塞或机械压迫引起。目前有多种治疗方法,应根据患者的期望、根本原因、预期寿命和功能状态进行调整。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Advancing care in malignant gastric outlet obstruction: a contemporary review of management strategies.

Purpose of review: The aim of this review is to summarize the most pertinent data on management of malignant gastric outlet obstruction (MGOO), with an emphasis on recent updates.

Recent findings: Traditionally, options to restore luminal patency in patients with MGOO were surgical gastrojejunostomy (SGJ) and endoscopic insertion of an enteral stent. The latter was reserved for patients with poor performance status or anticipated survival less than 2 months. Endoscopic gastroenterostomy (EUS-GE) is a newer technique that aims to mimic a SGJ and involves placement of a lumen apposing metal stent (LAMS) from the stomach directly into the jejunum. In a recent randomized trial of EUS-GE vs. enteral stent, the former was associated with reduced re-interventions, improved stent patency, and improved patient reported eating habits. Recent publications suggest that EUS-GE may offer substantial advantages over S-GJ; a randomized trial is currently underway. Venting gastrostomy may be the most suitable option for patients with markedly impaired gastric motility or with multiple luminal obstructions.

Summary: MGOO is a debilitating late complication of advanced upper gastrointestinal malignancies, resulting from blockage or mechanical compression of the distal stomach, pyloric antrum or duodenum. Various modalities are currently available, and should be tailored to patient's expectations, underlying cause, life expectancy, and functional status.

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来源期刊
Current Opinion in Gastroenterology
Current Opinion in Gastroenterology 医学-胃肠肝病学
CiteScore
5.30
自引率
0.00%
发文量
137
审稿时长
6-12 weeks
期刊介绍: ​​​​​​​Published bimonthly and offering a unique and wide ranging perspective on the key developments in the field, each issue of Current Opinion in Gastroenterology features hand-picked review articles from our team of expert editors. With twelve disciplines published across the year – including gastrointestinal infections, nutrition and inflammatory bowel disease – every issue also contains annotated references detailing the merits of the most important papers.
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