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Endoscopic nasogastric tube insertion for treatment of benign afferent loop obstruction after radical gastrectomy for gastric cancer: A 16-year retrospective single-center study.
Medicine (Baltimore) 2019; 98(28):e16475M

Abstract

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.

Authors+Show Affiliations

Department of Digestion.Department of Gastrointestinal Surgery, Liaocheng People's Hospital, Liaocheng, Shandong Province, China.Department of Gastrointestinal Surgery, Liaocheng People's Hospital, Liaocheng, Shandong Province, China.Department of Digestion.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31305482

Citation

Cao, Yuning, et al. "Endoscopic Nasogastric Tube Insertion for Treatment of Benign Afferent Loop Obstruction After Radical Gastrectomy for Gastric Cancer: a 16-year Retrospective Single-center Study." Medicine, vol. 98, no. 28, 2019, pp. e16475.
Cao Y, Kong X, Yang D, et al. Endoscopic nasogastric tube insertion for treatment of benign afferent loop obstruction after radical gastrectomy for gastric cancer: A 16-year retrospective single-center study. Medicine (Baltimore). 2019;98(28):e16475.
Cao, Y., Kong, X., Yang, D., & Li, S. (2019). Endoscopic nasogastric tube insertion for treatment of benign afferent loop obstruction after radical gastrectomy for gastric cancer: A 16-year retrospective single-center study. Medicine, 98(28), pp. e16475. doi:10.1097/MD.0000000000016475.
Cao Y, et al. Endoscopic Nasogastric Tube Insertion for Treatment of Benign Afferent Loop Obstruction After Radical Gastrectomy for Gastric Cancer: a 16-year Retrospective Single-center Study. Medicine (Baltimore). 2019;98(28):e16475. PubMed PMID: 31305482.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Endoscopic nasogastric tube insertion for treatment of benign afferent loop obstruction after radical gastrectomy for gastric cancer: A 16-year retrospective single-center study. AU - Cao,Yuning, AU - Kong,Xiangheng, AU - Yang,Daogui, AU - Li,Senlin, PY - 2019/7/16/entrez PY - 2019/7/16/pubmed PY - 2019/7/30/medline SP - e16475 EP - e16475 JF - Medicine JO - Medicine (Baltimore) VL - 98 IS - 28 N2 - 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. SN - 1536-5964 UR - https://www.unboundmedicine.com/medline/citation/31305482/Endoscopic_nasogastric_tube_insertion_for_treatment_of_benign_afferent_loop_obstruction_after_radical_gastrectomy_for_gastric_cancer:_A_16-year_retrospective_single-center_study L2 - http://Insights.ovid.com/pubmed?pmid=31305482 DB - PRIME DP - Unbound Medicine ER -