Endoscopic nasogastric tube insertion for treatment of benign afferent loop obstruction after radical gastrectomy for gastric cancer
| Autor: | Yuning Cao, Daogui Yang, Xiangheng Kong, Senlin Li |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
medicine.diagnostic_test business.industry Fistula medicine.medical_treatment Perforation (oil well) Adhesion (medicine) General Medicine Anastomosis medicine.disease Endoscopy Surgery 03 medical and health sciences 0302 clinical medicine 030220 oncology & carcinogenesis medicine Intubation Gastrectomy 030212 general & internal medicine business Complication |
| Zdroj: | Medicine. 98:e16475 |
| ISSN: | 1536-5964 0025-7974 |
| Popis: | Afferent loop obstruction is an uncommon complication associated with Billroth-II distal gastrectomy. Inappropriate treatment may result in life-threatening events as perforation and peritonitis. For the benign afferent loop obstruction, Braun or Roux-en-Y reconstruction has been reported as the choice. However, the edematous afferent loop may result in anastomotic fistula. In this study, a less invasive technique was described for treatment of benign afferent loop obstruction. The aim of this study was to investigate the effectiveness and safety of endoscopic nasogastric tube insertion for treatment of benign afferent loop obstruction.We conducted a retrospective review of the data of 2548 gastric cancer patients who underwent distal gastrectomy from January 2002 to January 2018. Patients who developed benign afferent loop obstruction were treated by this procedure. Outcomes were recorded. Follow-up was scheduled at 3, 6, and 12 months after the treatment.Twenty-six patients (1.0%) developed afferent loop obstruction. The median age, consisting of 19 men and 7 women, was 60 years (range 36-69 years). Of these 26 patients, 23 underwent the endoscopic treatment. The obstructive symptoms had a rapid relief in all the 23 patients. No one died due to this procedure. However, 2 patients underwent surgical treatment due to intestinal obstruction because of adhesion at >4 and 7 months after the endoscopic drainage, respectively.Endoscopic nasogastric tube insertion is an effective and safe procedure for treatment of benign afferent loop obstruction. In addition, it could be considered as the first step in treatment, especially in high-surgical-risk patients. |
| Databáze: | OpenAIRE |
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