OBJECTIVE: To assess the technical success, ability to eat, complications and clinical outcomes of patients with self-expandable metal stent (SEMS) placed for malignant upper gastrointestinal (GI) obstruction. MATERIALS AND METHODS: Data was collected retrospectively on patients who underwent SEMS placement for palliation of malignant upper GI obstruction by reviewing hospital charts from June 1998 to May 2011. Main outcome measurements were technical success, gastric outlet obstruction scoring system (GOOSS) score before and after treatment, complications, and survival. RESULTS: A total of 82 patients underwent SEMS placement with malignant upper GI obstruction. The initial SEMS placement was successful in 77 patients (93.9%). The mean GOOSS score was 0.56 before stenting and 1.92 (p < 0.001) after treatment. Complications arose in 12 patients (14.6%): stent migration in 1 patient (1.2%), perforation in 1 (1.2%), and obstruction of stent due to tumor ingrowth in 10 (12.2%). The median survival time after stenting was 52 days (6-445). CONCLUSION: SEMS placement is an effective and safe treatment for palliation of malignant upper GI obstruction. It provides lasting relief in dysphagia and improves the QOL of patients.
Adult ; Aged ; Aged, 80 and over ; Deglutition Disorders/physiopathology/prevention & control ; Equipment Design ; Female ; Humans ; Intestinal Neoplasms/physiopathology/*surgery ; Intestinal Obstruction/physiopathology/*surgery ; Male ; Metals ; Middle Aged ; *Palliative Care ; Postoperative Complications ; Retrospective Studies ; *Stents ; Survival Rate ; Treatment Outcome ; *Upper Gastrointestinal Tract

OBJECTIVETo observe the effect of Shenfu injection (SFI) on recovery of intestinal function, T-lymphocyte subsets (CD4, CD8 and CD4/CD8), interleukin-2 (IL-2) and tumor necrosis factor-alpha (TNF-alpha) in children with intestinal obstruction after surgical operation.

METHODSNinety-eight children suffering from intestinal obstruction after emergent surgical operation were divided into the SFI group (n = 50, treated with SFI after operation) and the control group (n = 48, treated with surgical operation alone). The intestinal function recovery rate (IFRR), T-lymphocyte subsets, serum levels of IL-2 and TNF-alpha in them were observed.

RESULTSAfter being treated for 7 days, the IFRR in the SFI group was 84.0%, which was significantly higher than that in the control group (62.5%, P < 0.05). CD4, CD4/CD8 levels increased in the SFI group after treatment (P < 0.05), while in the control group, CD8 increased significantly after treatment (P < 0.05) and higher than that in SFI group (P < 0.01). IL-2 level was much higher in the SFI group after treatment than that in the control group (P < 0.05). TNF-alpha level significantly lowered in both groups (P < 0.01), and the level in the SFI group was lower than that in the control group (P < 0.05).

CONCLUSIONSFI could promote the recovery of intestinal function, improve and regulate the immune function of the children after operation for intestinal obstruction.

CD4-CD8 Ratio ; Child, Preschool ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Gastrointestinal Motility ; drug effects ; Humans ; Immunity, Cellular ; Infant ; Interleukin-2 ; blood ; Intestinal Obstruction ; drug therapy ; immunology ; physiopathology ; surgery ; Male ; Phytotherapy ; Postoperative Period ; Recovery of Function ; Tumor Necrosis Factor-alpha ; metabolism