0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Invited Critique |

Stomach-Partitioning Gastrojejunostomy for Gastroduodenal Outlet Obstruction—Invited Critique

Robert A. Kozol,, MD
Arch Surg. 2007;142(7):611. doi:10.1001/archsurg.142.7.611.
Text Size: A A A
Published online

Extract

Kubota et al offer an alternative procedure for the relief of the vexing problem of malignant GOO in patients with tumors that are not resectable. While their procedure (SPGJ) may be a useful addition to available options, the suggestion that this is a fair comparison with endoscopic stenting is misleading. In the study by Kubota et al, Figure 3 reveals that 81% of patients in both groups were dead at 1-year follow-up. However, the median survival in the stent group was only 2.8 months (compared with 7.3 months in the SPGJ group). The patients in the stent group weighed a mean of 10 kg less than those in the SPGJ group. Finally, almost half of the stent group had advanced pancreatic or ovarian cancer. These facts strongly suggest that the patients in the stent group were more ill or had more advanced malignant neoplasms. This may well represent proper patient selection, but it precludes an “apples to apples” comparison.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
/>
First page PDF preview

Figures

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Topics
Jobs
brightcove.createExperiences();