Arterial embolization in the treatment of bleeding in inoperable gastric cancer: Have all the issues been resolved?
https://doi.org/10.34215/1609-1175-2021-2-89-92
Abstract
Clinical observation of the gastric bleeding for 64 years old patient having inoperable gastric cancer. Taking into account the low efficiency of the conservative and futility of the endoscopic treatment the embolization of the left gastric artery with the calibrated microsphere Embosphere (Biosphere Medical S.A.) through femoral approach was used. The occlusion of branches of the left gastric artery and the hemostasis was achieved. Tricky and unsolved issues of applying low-invasive bleeding treatment methods in case of malignant gastric tumors are discussed.
About the Authors
A. V. PavlovRussian Federation
MD
22 Sadovaya St., Vladivostok, 690078, Russian Federation
A. P. Murashkin
Russian Federation
MD
22 Sadovaya St., Vladivostok, 690078, Russian Federation
S. P. Borovsky
Russian Federation
MD, PhD, professor; surgeon
2 Ostryakova Ave., Vladivostok, 690002, Russian Federation
R. A. Pantileykin
Russian Federation
MD,
22 Sadovaya St., Vladivostok, 690078, Russian Federation
References
1. Kim YI, Choi IJ. Endoscopic management of tumor bleeding from inoperable gastric cancer. Clin Endosc. 2015;48(2):121–7.
2. Savides TJ, Jensen DM, Cohen J, Randall GM, Kovacs TO, Pelayo E, et al. Severe upper gastrointestinal tumor bleeding: endoscopic findings, treatment, and outcome. Endoscopy. 1996;28:244–8.
3. Sheibani S, Kim JJ, Chen B, Park S, Saberi B, Keyashian K, et al. Natural history of acute upper GI bleeding due to tumours: Short-term success and long-term recurrence with or without endoscopic therapy. Aliment Pharmacol Ther. 2013;38:144–50.
4. Kawabata H, Hitomi M, Motoi S. Management of bleeding from unresectable gastric cancer. Biomedicines. 2019;7(3):54. doi: 10.3390/biomedicines7030054
5. Shabunin AV, Grekov DN, Korzheva IYu, Bagateliya ZA, Tsurkan VA, Gugnin AV. The staged treatment of locally advanced stomach cancer complicated by relapsing hemorrhage under conditions of the multi-speciality hospital. Russian Journal of Evidence-Based Gastroenterology. 2017;4:78–84 (In Russ).
6. Loffroy R, Guiu B, D’Athis P, Mezzetta L, Gagnaire A, Jouve JL, et al. Arterial embolotherapy for endoscopically unmanageable acute gastroduodenal hemorrhage: Predictors of early rebleeding. Clin Gastroenterol Hepatol. 2009;7(5):515–23.
7. So JB, Yam A, Cheah WK, Kum CK, Goh PM. Risk factors related to operative mortality and morbidity in patients undergoing emergency gastrectomy. Br J Surg. 2000;87(12):1702–7.
8. Koh KH, Kim K, Kwon DH, Chung BS, Sohn JY, Ahn DS, et al. The successful endoscopic hemostasis factors in bleeding from advanced gastric cancer. Gastric Cancer. 2013;16(3):397–403.
9. Kennoki N, Saguchi T, Otaka J, Makuuchi Y, Watanabe T, Katayanagi S, et al. Salvage embolization and histologic analysis of gastric cancer with hemorrhagic shock using spherical embolic material. Pol J Radiol. 2017;82:364–70.
10. Marmo R, Del Piano M, Rotondano G, Koch M, Bianco MA, Zambelli A, et al. Mortality from nonulcer bleeding is similar to that of ulcer bleeding in high-risk patients with nonvariceal hemorrhage: A prospective database study in Italy. Gastrointest Endosc. 2012;75(2):263–72.
11. Cho SB, Hur S, Kim HC, Jae HJ, Lee M, Kim M, et al. Transcatheter arterial embolization for advanced gastric cancer bleeding: A single-center experience with 58 patients. Medicine (Baltimore). 2020;99(15):e19630. doi: 10.1097/MD.0000000000019630
12. Han K, Ahmed BM, Kim M-D, Won JY, Lee DY, Kim GM, et al. Clinical outcome of transarterial embolization for postgastrectomy arterial bleeding. Gastric Cancer. 2017;20(5):887–94.
13. Lee HJ, Shin JH, Yoon HK, Ko GY, Gwon DI, Song HY, Sung KB. Transcatheter arterial embolization in gastric cancer patients with acute bleeding. Eur Radiol. 2009;19(4):960–5.
14. Su Z, Shu K, Kang M, Wang G. Pathological complete response from oral chemotherapy combined with trans-arterial chemotherapy and embolization in an unresectable gastric cancer patient: A case report. Medicine (Baltimore). 2019;98(25):e16075. doi:10.1097/MD.0000000000016075
15. Polysalov VN, Veryasova NN. Ground of potentials of combined treatment in locally advanced gastric cancer. Oncology Bulletin Of The Volga Region. 2010;2:10–4 (In Russ).
Review
For citations:
Pavlov A.V., Murashkin A.P., Borovsky S.P., Pantileykin R.A. Arterial embolization in the treatment of bleeding in inoperable gastric cancer: Have all the issues been resolved? Pacific Medical Journal. 2021;(2):89-92. (In Russ.) https://doi.org/10.34215/1609-1175-2021-2-89-92