Abstract
BackgroundMalignant gastric outlet obstruction (GOO) is commonly associated with the presence of peritoneal carcinomatosis (PC) and preferably treated by surgical gastrojejunostomy (GJJ) in patients with good performance. Here, we aim to investigate the role of PC as a risk factor for perioperative morbidity and mortality in patients with GOO undergoing GJJ.MethodsPerioperative data of 72 patients with malignant GOO who underwent palliative GJJ at our institution between 2010 and 2019 were collected within an institutional database.To compare perioperative outcomes of patients with and without PC, extensive group analyses were carried out.ResultsA set of 39 (54.2%) patients was histologically diagnosed with concomitant PC while the remaining 33 (45.8%) patients showed no clinical signs of PC. In-house mortality due to surgical complications was significantly higher in patients with PC (9/39, 23.1%) than in patients without PC (2/33, 6.1%, p = .046). Considerable differences were observed in terms of surgical complications such as anastomotic leakage rates (2.8% vs. 0%, p = .187), delayed gastric emptying (33.3% vs. 15.2%, p = .076), paralytic ileus (23.1% vs. 9.1%, p = .113), and pneumonia (17.9% vs. 12.1%, p = .493) without reaching the level of statistical significance.ConclusionsPC is an important predictor of perioperative morbidity and mortality patients undergoing GJJ for malignant GOO.
Highlights
Malignant gastric outlet obstruction (GOO) is commonly associated with the presence of peritoneal carcinomatosis (PC) and preferably treated by surgical gastrojejunostomy (GJJ) in patients with good performance
GJJ is usually performed in Bednarsch et al World Journal of Surgical Oncology (2020) 18:25 case of GOO if the patient is intraoperatively diagnosed with PC or the primary tumor related to GOO is intraoperatively considered as technically not resectable [7]
Patient cohort A total of 72 patients underwent palliative GJJ due to malignant GOO at our institution from 2010 to 2019
Summary
Malignant gastric outlet obstruction (GOO) is commonly associated with the presence of peritoneal carcinomatosis (PC) and preferably treated by surgical gastrojejunostomy (GJJ) in patients with good performance. The presence of GOO in patients with advanced cancer is associated with dehydration and malnutrition and significantly impacts the quality of life (QoL) due to symptoms like nausea, pain, weight loss, and recurrent vomiting [1, 2]. This deterioration of the patient’s general condition and performance often results in interruption of Surgical gastrojejunostomy (GJJ) has been considered as the mainstay of treatment for GOO [4]. GJJ is usually performed in Bednarsch et al World Journal of Surgical Oncology (2020) 18:25 case of GOO if the patient is intraoperatively diagnosed with PC or the primary tumor related to GOO is intraoperatively considered as technically not resectable [7]
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