Treatment Strategy in Patients with Gastric Outlet Stenosis at the Multidisciplinary Center

Background. Gastric outlet stenosis is one of the most frequent and severe complications of gastric cancer; it significantly limits the possibility of antitumor therapy and worsens the prognosis of the disease. Gastric outlet stenosis develops in 15–30% of patients with distal forms of gastric cancer. According to current research, the median overall survival in palliative care for patients with gastric obstruction ranges from 3 to 6 months after stenting and from 6 to 12 months after surgical bypass anastomosis.

The aim of the study was to evaluate the results of treatment of patients with gastric outlet stenosis, taking into account: the timing of the start of chemotherapy, the timing of recovery of enteral nutrition, the duration of hospitalization, the frequency of complications, the frequency of repeated interventions, and overall patient survival.

Materials and methods. A retrospective, single-sample study was conducted. The study included 183 patients. Unlike a number of studies, the evaluation of treatment effectiveness included not only the timing of the start of chemotherapy, but also the timing of recovery of enteral nutrition, the duration of hospitalization, the frequency of complications, the need for repeated interventions, and overall survival rates.

Results. The majority of patients (58.47%) were admitted with stage IV cancer. After endoscopic stenting, the resumption of oral food intake occurred most quickly — on average within 1–3 days, while most patients could take liquid and soft food in the first days after the intervention. The earliest time to start chemotherapy was observed in patients after performing radical surgery — 25.2 days. The shortest period of hospitalization was also observed in patients who underwent stenting and amounted to 5–7 days.

Conclusion. The results obtained demonstrate that despite the use of modern treatment methods, there is still a high proportion of late-stage cases of the disease and the need for further optimization of treatment tactics.

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