Treatment of gastric outlet obstruction that results from unresectable gastric cancer: Current evidence

Table 1 Characteristics and main results of two reviews

Review	Year	Study type			Primary tumor			Procedure		Favorable groupregarding several variables
		Retro	Pro	RCT	Stomach	Pancreas	Others	GJ	ES	Toleration of oral intake1	Time to oral intake2(d)	Hospital stay3(d)	Complication
1	2010	10	1	2	94 (18.3%)	240 (46.7%)	180 (35.0%)	255 (LGJ 37)	244	ES	ES (2.0 d)	ES (9.4 d)	GJ is approximately equal to ES
2	2012	0	3	3	55 (28.6%)	86 (44.8%)	51 (26.6%)	92 (LGJ 0)	74	GJ (not-RCT)	ES (2.1-5.0 d)	ES (2.5-7.0 d)	Major: GJ is approximately equal to ES Minor: ES

¹Patients were more likely to tolerate oral intake following ES than GJ in Review 1; however, Review 2 reported the opposite results. The difference was only significant in the non-RCT group;

²The mean time from the procedure to initiate oral intake was 7 d (Review 1) and 3.6 d (Review 2) less for ES compared with GJ;

³The mean length of hospital stay was reduced by 12 d (Review 1) and 7.5 d (Review 2) for ES compared with GJ. Retro: Retrospective; Pro: Prospective; RCT: Randomized controlled trial; GJ: Gastrojejunostomy; ES: Endoscopic stenting; LGJ: Laparoscopic GJ.

Table 2 Patient demographics and main results in two reviews

Ref.	Study type	Procedure		Performance status		Comparison between GJ and ESregarding several variables
		GJ	ES	GJ	ES	Toleration of oral intake	GOO recurrence	Time to oral intake	Hospital stay	Complication
Fiori et al[53]	Prospective	9 (LGJ 0)	9	NR	NR	GJ is approximately equal to ES	GJ (0%) < ES (33%)a	GJ (6.3 d)	GJ (10 d)	GJ: SSI, bleeding, ventral hernia
								ES (3.1 d)	ES (4.8 d)	ES: Stent dislocation, re-obstruction
No et al[54]	Retrospective	41 (LGJ 9)	72	0-11: 68.3%	0-11: 59.7%	GJ (95.1%) is approximately equal to ES (87.5%)	GJ (12.2%) < ES (44.4%)a	GJ (16 d) > ES (10 d)a	GJ (18 d) > ES (16 d)3	GJ is approximately equal to ES
				21: 31.7%	21: 40.3%
Keränen et al[55]	Retrospective	21 (LGJ 0)	50	I-II2: 90.5%	I-II2: 58%	GJ (81%) is approximately equal to ES (88%)	GJ (9.5%)	GJ (4 d) > ES (1 d)a	GJ (8 d) > ES (3 d)a	GJ (10%)
				III-IV2: 9.5%	III-IV2: 42%		ES (24%)			ES (26%)

¹ECOG performance status;

²WHO score;

³Not significant;

^aP < 0.05. GJ: Gastrojejunostomy; ES: Endoscopic stenting; LGJ: Laparoscopic GJ; NR: Not reported; ECOG: Eastern Cooperative Oncology Group; WHO: World Health Organization.