Covered <i>vs.</i> uncovered self-expandable metal stents for palliation of malignant afferent loop obstruction: a multicenter study

Wang, Chaoyang; Niu, Huanzhang; Yang, Chongtu; Liu, Jiacheng; Wang, Yingliang; Ju, Shuguang; Bai, Yansen; Ren, Jianzhuang; Xiong, Bin

doi:10.1080/00365521.2021.2009023

Cited by 2 publications

(3 citation statements)

References 29 publications

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“…However, it is still difficult to reach the stricture site in cases of severe postoperative adhesions or peritoneal dissemination [7]. In addition, stent dysfunction rates were considerably high (0-38%) due to tumor ingrowth in uncovered SEMSs and migration in covered SEMSs [25]. Gutierrez et al reported an indirect comparison of transmural and transluminal approaches, showing a significantly lower reintervention rate for the former (16.6% vs. 76.5%, p < 0.001) [12].…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Ultrasound-Guided Gastrojejunostomy for Malignant Afferent Loop Syndrome Using a Fully Covered Metal Stent: A Multicenter Experience

Matsubara

Takahashi

Takahara

et al. 2023

JCM

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Background: Endoscopic-ultrasound-guided gastrojejunostomy (EUS-GJ) can be a new alternative for patients with malignant afferent loop syndrome (MALS). However, a fully covered self-expandable metal stent (FCSEMS) has not been well investigated in this setting. Methods: This is a multicenter retrospective cohort study. Consecutive patients that underwent EUS-GJ using a FCSEMS for MALS between April 2017 and November 2022 were enrolled. Primary outcomes were technical and clinical success rates. Secondary outcomes were adverse events, recurrent symptoms, and overall survival. Results: Twelve patients (median age: 67.5 years (interquartile range: 58–74.8); 50% male) were included. The most common primary disease and type of previous surgery were pancreatic cancer (67%) and pancreatoduodenectomy (75%), respectively. Technical success and clinical success were achieved in all patients. Procedure-related adverse events occurred in one patient (8%) with mild peritonitis. During a median follow-up of 96.5 days, one patient (8%) had recurrent symptoms due to the EUS-GJ stent dysfunction; including biliary events unrelated to the EUS-GJ stent, five patients (42%) had recurrent events. The median overall survival was 137 days. Nine patients (75%) died due to disease progression. Conclusions: EUS-GJ with a FCSEMS seems safe and effective for MALS with high technical and clinical success rates and an acceptable recurrence rate.

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Section: Discussionmentioning

confidence: 99%

Endoscopic Ultrasound-Guided Gastrojejunostomy for Malignant Afferent Loop Syndrome Using a Fully Covered Metal Stent: A Multicenter Experience

Matsubara

Takahashi

Takahara

et al. 2023

JCM

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“…Endoscopic transluminal SEMS insertion for malignant ALO with overtube-assisted insertion and TTS delivery has been reported in several studies ( Table 4 ) [ 8 , 9 , 10 , 11 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ]. Most previous reports are case reports, and reports on endoscopic SEMS placement in the setting of Roux-en-Y reconstruction are also limited.…”

Section: Discussionmentioning

confidence: 99%

“…One patient was managed by additional SEMS placement and the other patient was treated conservatively due to poor general condition. Recently, Wang et al reported a large multicenter retrospective study comparing covered and uncovered SEMS for malignant ALO [ 32 ]. The median time to stent dysfunction was 69 days, with no significant difference in stent dysfunction between the covered and uncovered SEMS groups.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Transluminal Stent Placement for Malignant Afferent Loop Obstruction

Yonekura

Sasaki

Mie

et al. 2022

JCM

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Background: Malignant afferent loop obstruction (ALO) is rare condition and is difficult to manage. Endoscopic transluminal treatment has become easier with the advent of balloon-assisted enteroscopes with a large working channels and self-expandable metal stent (SEMS) with a 9 Fr delivery system. Methods: From July 2016 to March 2022, 22 patients with symptomatic malignant ALO who underwent endoscopic transluminal treatment (Initial cohort), of which 18 patients received endoscopic transluminal SEMS placement (SEMS cohort), were retrospectively evaluated. We evaluated outcomes of endoscopic transluminal treatment and long-term outcomes of SEMS placement for malignant ALO. Results: In the Initial cohort, technical and clinical success rates were both 95.5%. The median procedural time was 28.0 min. One case of guidewire-induced micro-perforation occurred as an early complication (4.5%). In the SEMS cohort, and no early complication was observed. Recurrent obstruction occurred in two cases (11.1%) during the follow-up period (median: 102 days). One was managed by additional SEMS placement and the other was treated conservatively. Conclusions: High technical and clinical success was achieved by endoscopic transluminal treatment with short procedural time for malignant ALO. Endoscopic SEMS placement also appears to be safe and effective, and additional SEMS placement can be considered in cases of re-obstruction.

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Covered vs. uncovered self-expandable metal stents for palliation of malignant afferent loop obstruction: a multicenter study

Cited by 2 publications

References 29 publications

Endoscopic Ultrasound-Guided Gastrojejunostomy for Malignant Afferent Loop Syndrome Using a Fully Covered Metal Stent: A Multicenter Experience

Endoscopic Ultrasound-Guided Gastrojejunostomy for Malignant Afferent Loop Syndrome Using a Fully Covered Metal Stent: A Multicenter Experience

Endoscopic Transluminal Stent Placement for Malignant Afferent Loop Obstruction

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