Endoscopic Gastrointestinal Anastomosis Using Lumen-apposing Metal Stent (LAMS) for Benign or Malignant Etiologies

Hakim, Seifeldin; Khan, Zubair; Shrivastava, Ashish; Köroğlu, Emine; Patil, Prithvi; Akyüz, Filiz; Akyüz, Ümit; Ramireddy, Srinivas; Badillo, Ricardo; DaVee, Tomas; Thosani, Nirav

doi:10.1097/mcg.0000000000001453

Cited by 10 publications

(4 citation statements)

References 23 publications

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“…In overall analysis, LAMS and BFMS were regarded the same kind, however in subgroup analysis, they were separated. Many studies have shown that the LAMS is safer and more effective for bile collection for biliary and gallbladder illnesses [ 43–46 ]. Single-arm studies also showed LAMS are safe and effective.…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of lumen-apposing metal stents and double-pigtail plastic stents for endoscopic ultrasound-guided drainage of walled-off necrosis; a systematic review and meta-analysis

Khizar

et al. 2023

Annals of Medicine

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Background Patients with walled-off necrosis (WON) are still challenging to treat safely and effectively. Recently, double-pigtail plastic stents (DPS), bi-flanged metallic stents (BFMS), and lumen-apposing metal stents (LAMS) have been employed with endoscopic ultrasound-guided (EUS-guided) drainage. However, there is little solid evidence to support the effectiveness and safety of using stents. This study aims to compare the outcomes of the LAMS and the PS. Method Till July 2022, a thorough database search was done, and studies that met the criteria were chosen. By using the RevMan software, the technical and clinical success and other secondary outcomes were calculated. Subgroup analysis was performed between the LAMS and the BFMS. Results Fifteen studies (two randomized controlled trials and thirteen observational) with 687 patients receiving metal stents and 771 patients receiving plastic stents were selected for final analysis. There was no significant risk of bias or publication bias. The odds ratios (OR) for technical and clinical success were 0.36 (95% confidence interval (95% CI) 0.08, 1.52) and 2.26 (95%CI 1.62, 3.15), respectively. The OR for overall adverse events was 0.74 (95% CI 0.41, 1.34). In subgroup analysis, the LAMS and the BFMS showed the same outcomes. Conclusion Compared to DPS, LAMS had better clinical outcomes and fewer side effects when treating patients with WON.

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Section: Discussionmentioning

confidence: 99%

Safety and efficacy of lumen-apposing metal stents and double-pigtail plastic stents for endoscopic ultrasound-guided drainage of walled-off necrosis; a systematic review and meta-analysis

Khizar

et al. 2023

Annals of Medicine

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“…Stent misdeplyoment was seen on 9.5% cases and re-interventions (any interventions during study period for stent malfunction or migration) were performed in 6% cases. [9 ▪ ]. The study included 203 patients (75.5%) with malignant cause and had a median follow up of 114 days.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic approaches to small intestinal strictures

Ashat

Abiad

Khashab

2023

Current Opinion in Gastroenterology

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Purpose of review Gastric outlet obstruction (GOO) occurs from benign or malignant causes. Historically, the treatment of benign strictures revolved around endoscopic balloon dilation, whereas, in the case of malignant strictures, the placement of self-expandable metallic stents was the focus. The advent of lumen-apposing metal stent has opened new horizons in addressing shortcomings of enteral stenting and surgical gastroenterostomies. The purpose of the review is to discuss the endoscopic approaches to small bowel strictures and to examine the supporting data behind each practice. Recent findings Given the risk and futility of balloon dilation for malignant strictures, enteral stenting is pursued in patients who are poor surgical candidates and with life expectancy less than 6 months. For patients with longer survival, surgical gastroenterostomy (S-GE) should be considered. Recent data have shown comparable technical and clinical success rates between EUS-gastroenterostomy and S-GE but with lower adverse event rate and hospital length of stay. Summary In recurrent benign strictures and malignant GOO, EUS-GE has recently gained momentum in providing an effective and a well tolerated alternative. Individualized therapy centered around the patient's prognosis and preference while factoring in the local expertise for the specific indication is vital.

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“…The recent meta-analysis showed that EUS-GE had a 92%–94% technical success and a 90%–91% clinical success. [ 1 2 3 ] Stent misdeployment is not an unusual pitfall occurring in 9.5% of reported cases. [ 3 ] The mobility of the small bowel may result in loss of visualization and subsequent stent misdeployment.…”

mentioning

confidence: 99%

“…[ 1 2 3 ] Stent misdeployment is not an unusual pitfall occurring in 9.5% of reported cases. [ 3 ] The mobility of the small bowel may result in loss of visualization and subsequent stent misdeployment. [ 4 ] Insertion of the guidewire can push the small bowel away, thus increasing the risk of stent misdeployment.…”

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confidence: 99%

Pitfalls in stent deployment during EUS-guided gastrojejunostomy using Hot Axios™ (with videos)

et al. 2021

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Endoscopic Gastrointestinal Anastomosis Using Lumen-apposing Metal Stent (LAMS) for Benign or Malignant Etiologies

Abstract: FIGURE 8. Forest plot for clinical success for malignant etiologies. FIGURE 9. Forest plot for technical success for retrospective studies.

Cited by 10 publications

References 23 publications

Safety and efficacy of lumen-apposing metal stents and double-pigtail plastic stents for endoscopic ultrasound-guided drainage of walled-off necrosis; a systematic review and meta-analysis

Safety and efficacy of lumen-apposing metal stents and double-pigtail plastic stents for endoscopic ultrasound-guided drainage of walled-off necrosis; a systematic review and meta-analysis

Endoscopic approaches to small intestinal strictures

Pitfalls in stent deployment during EUS-guided gastrojejunostomy using Hot Axios™ (with videos)

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