7025 Improvement of qol by stent treatment for malignant gastrointestinal tract stenosis.

2000
Introduction The stent treatment for patients with malignant gastrointestinal tract stenosishas become one of the popular endoscopic treatments and has become widespread at manyhospitals. Manyreports on stent treatments are about the experiences of using stents whereas few studies evaluated and discussed the improvements of QOL. This report aims to evaluate the differences in the improvement of QOL by stent treatments according to the site of stenosis. Subjects Of these patients, the subjects were 93 cases in whom stent placement was successful. The lesions were esophagostenosis in 39, gastric outlet obstruction(GOO) in 39, and large intestinal stenosisin 15 cases. The length of stenosisbefore operation was 4.56, 5.54 and 5.67 cm, respectively, and the performance status (PS) before operation was 3.15, 3.18 and 3.13, respectively.With the dysphagiascore (DS) as 0 point- no dysphagia, 1 point- dysphgia for solid food, 2 points- dysphagiafor semi-solid food, and 3 points- dysphagiafor liquids, DS before operation was 2.51, 2.69 and 2.40, respectively. Method The improvement in QOL according to the site of stenosiswas evaluated, by clarifying the eating conditions before and after the operation, the improvement in the constitutional symptoms, the ratio of returning home, survival time, and home staying time. Results PS after operation was improved to 2.28, 2.39 and 2.73, respectively. DS after operation was also improved to 1.33, 1.56, and 1.53, respectively. The ratio of returning home was 53.8, 46.2 and 50.0%, respectively, and the ratio was high in esophagostenosis patients. Also the mean survival time was 199.8, 160.2 and 229.8 days, respectively. The meal home staying period was 102.9, 69.1 and 157.2 days, respectively. Discussion (1) PS and DS were improved by stenting at all sites of stenosis. (2) The ratio of returning home was not different at all sites of stenosis. (3)Although the survival time was not different, there was a tendency that home staying time was prolonged in patients with esophgostenosis and large intestinal stenosis. Conclusion Stenting is effective not only in esophagostenosis but also in GOO and large intestinal stenosis, and contributes in the improvement of the QOL.
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