Laparoscopic versus EUS-guided gastroenterostomy for gastric outlet obstruction: an international multicenter propensity score–matched comparison (with video)

Bronswijk, Michiel; Vanella, Giuseppe; Malenstein, Hannah van; Laleman, Wim; Jaekers, Joris; Topal, Baki; Daams, Freek; Besselink, Marc G.; Arcidiacono, Paolo Giorgio; Voermans, Rogier P.; Fockens, Paul; Larghi, Alberto; Wanrooij, Roy L.J. van; Merwe, Schalk van der

doi:10.1016/j.gie.2021.04.006

Cited by 70 publications

(76 citation statements)

References 38 publications

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“…However, EUS-GE patients experienced shorter delays to resumption of oral intake and chemotherapy, had shorter lengths of stay, and reduced hospital costs. Perez-Miranda et al [ 112 ] and Bronswijk et al [ 113 ] compared retrospectively EUS-GE and laparoscopic SGJ, reporting no differences in technical and clinical success between groups, but EUS-GE had significantly lower rate of AEs, reduced mean time to oral intake and shorter median hospital stays.…”

Section: Lumen-apposing Metal Stents (Lams)mentioning

confidence: 99%

Futuristic Developments and Applications in Endoluminal Stenting

Ferreira‐Silva

Medas

Girotra

et al. 2022

Gastroenterology Research and Practice

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Endoscopic stenting is a well-established option for the treatment of malignant obstruction, temporary management of benign strictures, and sealing transmural defects, as well as drainage of pancreatic fluid collections and biliary obstruction. In recent years, in addition to expansion in indications for endoscopic stenting, considerable strides have been made in stent technology, and several types of devices with advanced designs and materials are continuously being developed. In this review, we discuss the important developments in stent designs and novel indications for endoluminal and transluminal stenting. Our discussion specifically focuses on (i) biodegradable as well as (ii) irradiating and drug-eluting stents for esophageal, gastroduodenal, biliary, and colonic indications, (iii) endoscopic stenting in inflammatory bowel disease, and (iv) lumen-apposing metal stent.

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Section: Lumen-apposing Metal Stents (Lams)mentioning

confidence: 99%

Futuristic Developments and Applications in Endoluminal Stenting

Ferreira‐Silva

Medas

Girotra

et al. 2022

Gastroenterology Research and Practice

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“…Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) is a relatively new, minimally invasive technique that provides rapid relief of symptoms associated with low morbidity and long-term patency of the anastomosis. Recently, multiple retrospective series comparing EUS-GE with surgical gastroenterostomy have indeed shown similarly high technical and clinical success rates, with significantly faster relief of symptoms, shorter hospital stay, and lower morbidity with EUS-GE [9][10][11][12]. Data comparing EUS-GE and duodenal stenting are limited, with most studies not controlling for confounders, making interpretation of outcomes data difficult [13,14].…”

Section: Introductionmentioning

confidence: 99%

Endoscopic ultrasound-guided gastroenterostomy versus duodenal stenting for malignant gastric outlet obstruction: an international, multicenter, propensity score-matched comparison

et al. 2022

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Background Endoscopic duodenal stenting is the current standard treatment for malignant gastric outlet obstruction (GOO) in patients with limited life expectancy. However, duodenal stenting is prone to stent dysfunction. Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) is a novel technique with potentially superior stent patency. We compared clinical success, safety, and stent dysfunction of EUS-GE and duodenal stenting in patients with malignant GOO using propensity score matching. Methods This international, multicenter, retrospective study analyzed consecutive patients undergoing EUS-GE or duodenal stenting for GOO between 2015 and 2021 in three European centers. Primary outcomes were clinical success (GOO scoring system [GOOSS] ≥ 2) and stent dysfunction (GOOSS ≤ 1 after initial clinical success). A propensity score matching (1:1) analysis was performed using age, sex, underlying disease, disease stage, ascites, and peritoneal carcinomatosis as variables. Results 214 patients underwent EUS-GE (n = 107) or duodenal stenting (n = 107). After propensity score matching, 176 patients were matched and compared. Technical success rates for EUS-GE and duodenal stenting were 94 % (95 %CI 89 %–99 %) vs. 98 % (95 %CI 95 %–100 %), respectively (P = 0.44). Clinical success rates were 91 % (95 %CI 85 %–97 %) vs. 75 % (95 %CI 66 %–84 %; P = 0.008). Stent dysfunction occurred in 1 % (95 %CI 0–4 %) vs. 26 % (95 %CI 15 %–37 %) of patients (P < 0.001). Adverse event rate was 10 % (95 %CI 4 %–17 %) vs. 21 % (95 %CI 12 %–29 %; P = 0.09). Conclusion EUS-GE had higher clinical success and lower stent dysfunction, with similar safety, compared with duodenal stenting, suggesting that EUS-GE may be preferred over duodenal stenting in patients with malignant GOO.

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“…[ 10 13 ] There are radial, linear, and forward-viewing echoendoscopes. [ 14 15 16 ] The linear and forward-view echoendoscope allows the performance of EUS-FNA[ 17 18 ] and EUS guided interventions[ 19 20 21 ] and is gaining increasing popularity over the radial echoendoscope. However, the radial echoendoscope renders complete and straightforward views of lesions in the gastrointestinal wall and the common bile duct, which is vital in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a novel radial echoendosonoscope with a piezoelectric-composite transducer: An open-label, multicenter, randomized, parallel-group, noninferiority clinical trial

et al. 2021

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Background and Objectives: EUS is widely used in the clinical practice. This study aimed to evaluate the efficacy of a novel echoendoscope regarding image quality, maneuverability, stability of the entire machine system, and safety. Setting and Design: We conducted this open-label, multicenter, randomized, parallel-group, noninferiority clinical trial in three tertiary hospitals between November 2018 and April 2019. Subjects and Methods: One hundred and thirty patients were included. The stratified segment randomization method was employed. Sixty-five patients in the test group received an EUS examination using the new material radial echoendoscope, and 65 patients in the control group received an EUS examination using the existing endoscope. We recorded the image quality, maneuverability, stability of the entire machine system, and safety. For the main outcome, comprehensive image quality, the groups were compared with the noninferiority test, using the confidence interval method and 10% as the noninferiority threshold. The Pearson Chi-square test was used to compare the incidence of adverse events between the groups. Results: Sixty-five patients in the test group and 63 patients in the control group were analyzed. Two patients in control group did not complete an EUS examination due to machine problems. There were no significant differences in image quality, maneuverability of the echoendoscope, stability of the entire machine system, and safety between the groups. Conclusions: This new material radial echoendoscope showed good capabilities for image quality, maneuverability, stability of the entire machine system, and safety. Our data suggest that the new echoendoscope may provide an additional option for endoscopic physicians.

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Laparoscopic versus EUS-guided gastroenterostomy for gastric outlet obstruction: an international multicenter propensity score–matched comparison (with video)

Cited by 70 publications

References 38 publications

Futuristic Developments and Applications in Endoluminal Stenting

Futuristic Developments and Applications in Endoluminal Stenting

Endoscopic ultrasound-guided gastroenterostomy versus duodenal stenting for malignant gastric outlet obstruction: an international, multicenter, propensity score-matched comparison

Evaluation of a novel radial echoendosonoscope with a piezoelectric-composite transducer: An open-label, multicenter, randomized, parallel-group, noninferiority clinical trial

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