Reviewer's report 
 Stent versus gastrojejunostomy for the palliation of gastric outlet obstruction: a systematic review Title: 
 1  6 March 2007 Version: Date: 
 Iruru Maetani Reviewer: 
Reviewer's report: 
General 
The paper is a review article that focuses on the comparison between stent placement and surgical 
gastrojejunostomy for the palliation of gastric outlet obstruction. In the past, only two randomized trials between the two modalities have been reported and these two studies were conducted with a small sample 
size. Thus, a systematic review like this is significantly meaningful at present. Although this paper is well 
written, please clarify the following items. 
------------------------------------------------------------------------------- 
Major Compulsory Revisions (that the author must respond to before a decision on publication can be reached) 
None 
------------------------------------------------------------------------------- 
Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author 
can be trusted to correct) 
In the discussion section, you offer your opinion on covered stents. Although I agree with your opinion, you 
should refer to the articles regarding the use of covered stent for gastric outlet obstruction such as [Ref#23, 
25, 29, 30, 42] instead of esophageal obstruction [Ref#52]. 
P.7 Last line: A misspelled word “Giaturco” should be replaced with “Gianturco”. 
P.15 L.9 You say, “P.D. helped with ….” You mean “P.S.”. 
------------------------------------------------------------------------------- 
Discretionary Revisions (which the author can choose to ignore) 
You conclude that stent placement may be associated with more favorable results in patients with a 
relatively short life expectancy, while GJJ is preferable to patients with a more prolonged prognosis because 
the results show that recurrent obstructive symptoms were more common after stent placement (18% vs. 
1%). As time passes, the possibility of the stent occlusion probably increases. I think that stent obstruction 
probably occurs as a late-onset adverse effect unlike stent migration. To emphasize conclusion, however, it 
is desirable to display the period until recurrent obstructive symptoms are seen in reference to available 
data of published studies. 
 Accept after minor essential revisions What next?: 
 An article of importance in its field Level of interest: 
 Acceptable Quality of written English: 
 No, the manuscript does not need to be seen by a statistician. Statistical review: 
Declaration of competing interests: 
I declare that I have no competing interests. 
Reviewer's report 
 Stent versus gastrojejunostomy for the palliation of gastric outlet obstruction: a systematic review Title: 
 1  6 March 2007 Version: Date: 
 Iruru Maetani Reviewer: 
Reviewer's report: 
General 
The paper is a review article that focuses on the comparison between stent placement and surgical 
gastrojejunostomy for the palliation of gastric outlet obstruction. In the past, only two randomized trials between the two modalities have been reported and these two studies were conducted with a small sample 
size. Thus, a systematic review like this is significantly meaningful at present. Although this paper is well 
written, please clarify the following items. 
------------------------------------------------------------------------------- 
Major Compulsory Revisions (that the author must respond to before a decision on publication can be reached) 
None 
------------------------------------------------------------------------------- 
Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author 
can be trusted to correct) 
In the discussion section, you offer your opinion on covered stents. Although I agree with your opinion, you 
should refer to the articles regarding the use of covered stent for gastric outlet obstruction such as [Ref#23, 
25, 29, 30, 42] instead of esophageal obstruction [Ref#52]. 
P.7 Last line: A misspelled word “Giaturco” should be replaced with “Gianturco”. 
P.15 L.9 You say, “P.D. helped with ….” You mean “P.S.”. 
------------------------------------------------------------------------------- 
Discretionary Revisions (which the author can choose to ignore) 
You conclude that stent placement may be associated with more favorable results in patients with a 
relatively short life expectancy, while GJJ is preferable to patients with a more prolonged prognosis because 
the results show that recurrent obstructive symptoms were more common after stent placement (18% vs. 
1%). As time passes, the possibility of the stent occlusion probably increases. I think that stent obstruction 
probably occurs as a late-onset adverse effect unlike stent migration. To emphasize conclusion, however, it 
is desirable to display the period until recurrent obstructive symptoms are seen in reference to available 
data of published studies. 
 Accept after minor essential revisions What next?: 
 An article of importance in its field Level of interest: 
 Acceptable Quality of written English: 
 No, the manuscript does not need to be seen by a statistician. Statistical review: 
Declaration of competing interests: 
I declare that I have no competing interests. 
Please review this paper.
user
Reviewer's report 
 Stent versus gastrojejunostomy for the palliation of gastric outlet obstruction: a systematic review Title: 
 1  6 March 2007 Version: Date: 
 Iruru Maetani Reviewer: 
Reviewer's report: 
General 
The paper is a review article that focuses on the comparison between stent placement and surgical 
gastrojejunostomy for the palliation of gastric outlet obstruction. In the past, only two randomized trials between the two modalities have been reported and these two studies were conducted with a small sample 
size. Thus, a systematic review like this is significantly meaningful at present. Although this paper is well 
written, please clarify the following items. 
------------------------------------------------------------------------------- 
Major Compulsory Revisions (that the author must respond to before a decision on publication can be reached) 
None 
------------------------------------------------------------------------------- 
Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author 
can be trusted to correct) 
In the discussion section, you offer your opinion on covered stents. Although I agree with your opinion, you 
should refer to the articles regarding the use of covered stent for gastric outlet obstruction such as [Ref#23, 
25, 29, 30, 42] instead of esophageal obstruction [Ref#52]. 
P.7 Last line: A misspelled word “Giaturco” should be replaced with “Gianturco”. 
P.15 L.9 You say, “P.D. helped with ….” You mean “P.S.”. 
------------------------------------------------------------------------------- 
Discretionary Revisions (which the author can choose to ignore) 
You conclude that stent placement may be associated with more favorable results in patients with a 
relatively short life expectancy, while GJJ is preferable to patients with a more prolonged prognosis because 
the results show that recurrent obstructive symptoms were more common after stent placement (18% vs. 
1%). As time passes, the possibility of the stent occlusion probably increases. I think that stent obstruction 
probably occurs as a late-onset adverse effect unlike stent migration. To emphasize conclusion, however, it 
is desirable to display the period until recurrent obstructive symptoms are seen in reference to available 
data of published studies. 
 Accept after minor essential revisions What next?: 
 An article of importance in its field Level of interest: 
 Acceptable Quality of written English: 
 No, the manuscript does not need to be seen by a statistician. Statistical review: 
Declaration of competing interests: 
I declare that I have no competing interests. 
assistant