Su1286 ENDOSCOPIC ULTRASOUND-GUIDED GASTROJEJUNOSTOMY IS SUPERIOR TO DUODENAL SELF EXPANDABLE METAL STENT FOR PALLITAIVE TREATMENT OF MALIGNANT GASTRIC OUTLET OBSTRUCTTION: A COMPARATIVE CASE CONTROL STUDY

Vázquez-Sequeiros, Enrique; Sánchez-Aldehuelo, Rubén; Santiago, Enrique Rodríguez de; Peralta-Herce, Sandra; Súbtil, José Carlos; Aparicio, José Ramón; González-Húix, Ferrán; Yagüe, Andrés Sánchez; Gornals, Joan B.; Repiso, Alejandro; Guarner, Carlos; Foruny, José Ramón; Albillos, Agustı́n

doi:10.1016/j.gie.2020.03.2132

Cited by 7 publications

(18 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We were unable to analyze if one EUS-GE technique was superior to the other. In our analysis, only three studies reported on the location of obstruction 43 46 47 . This was duodenal bulb in 130 patients, second portion of duodenum in 190 patients and distal duodenum in 129 patients.…”

Section: Discussionmentioning

confidence: 93%

“…A total of five studies, with 659 patients were included in the final analysis 43 44 45 46 47 . A schematic diagram demonstrating our study selection is illustrated in Supplementary Fig.…”

Section: Resultsmentioning

confidence: 99%

“…All the included cohort studies were retrospective in design. Three studies were published as abstracts 45 46 47 , while two were published as full manuscripts. Two studies were conducted as single center experiences 43 45 , whereas the others were multi-center.…”

Section: Resultsmentioning

confidence: 99%

“…Details of the technique used for performing EUS-GE was described in only two studies 43 48 . Based on the New-Castle Ottawa scoring system, 3 studies 46 47 48 were considered to be of high quality and 2 studies 43 45 were considered to be of medium quality. There were no low-quality studies.…”

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

EUS-guided gastroenterostomy versus enteral stenting for gastric outlet obstruction: Systematic review and meta-analysis

et al. 2021

View full text Add to dashboard Cite

Abtract Background and study aims Endoscopic and surgical techniques have been utilized for palliation of gastric outlet obstruction (GOO). Enteral stenting (ES) is an established technique with high clinical success and low morbidity rate. Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) is a novel approach that aims to provide sustained palliation of GOO. We conducted a comprehensive review and meta-analysis to evaluate the effectiveness in terms of clinical and technical success, as well as the safety profile of EUS-GE and ES. Methods We searched multiple databases from inception through July 2020 to identify studies that reported on safety and effectiveness of EUS-GE in comparison to ES. Pooled rates of technical success, clinical success, and adverse events (AEs) were calculated. Study heterogeneity was assessed using I2% and 95 % confidence interval. Results Five studies including 659 patients were included in our final analysis. Pooled rate of technical and clinical success for EUS-GE was 95.2 % (CI 87.2-.98.3, I2 = 42) and 93.3 % (CI 84.4–97.3, I2 = 59) while for ES it was 96.9 % (CI 90.9–99, I2 = 64) and 85.6 % (CI 73–92.9, I2 = 85), respectively. Pooled rate of re-intervention was significantly lower with EUS-GE i. e. 4 % (CI 1.8–8.7, I2 = 35) compared to ES, where it was 23.6 % (CI 17.5–31, I2 = 35), p = 0.001. Pooled rates of overall and major AEs were comparable between the two techniques. Conclusion EUS-GE is comparable in terms of technical and clinical effectiveness and has a similar safety profile when compared to ES for palliation of GOO.

show abstract

Section: Discussionmentioning

confidence: 93%

“…A total of five studies, with 659 patients were included in the final analysis 43 44 45 46 47 . A schematic diagram demonstrating our study selection is illustrated in Supplementary Fig.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

EUS-guided gastroenterostomy versus enteral stenting for gastric outlet obstruction: Systematic review and meta-analysis

et al. 2021

View full text Add to dashboard Cite

show abstract

“…A total of seven studies involving 625 patients were included in the final analysis 22 23 24 25 26 27 40 . Single-arm studies on EUS-GE 12 17 18 41 42 43 44 , and/or comparing EUS-GE to only endoscopic stenting 19 45 46 47 were excluded. A schematic diagram demonstrating our study selection is illustrated in Supplementary Fig.…”

Section: Resultsmentioning

confidence: 99%

EUS-guided gastroenterostomy versus surgical gastroenterostomy for the management of gastric outlet obstruction: a systematic review and meta-analysis

et al. 2022

View full text Add to dashboard Cite

Background and study aims Surgical gastroenterostomy (SGE) has been the mainstay treatment for gastric outlet obstruction (GOO). The emergence of endoscopic ultrasound-guided gastroenterostomy (EUS-GE) presents a less invasive alternative for palliation of GOO. We conducted a comprehensive review and meta-analysis to compare the effectiveness and safety of EUS-GE compared to SGE. Methods Multiple electronic databases and conference proceedings up to April 2021 were searched to identify studies that reported on safety and effectiveness of EUS-GE in comparison to SGE. Pooled odds ratios (ORs) of technical success, clinical success, adverse events (AE) and recurrence, and pooled standardized mean difference (SMD) of procedure time and post-procedure length of stay (LOS) were calculated. Study heterogeneity was assessed using I 2 and Cochran Q statistics. Results Seven studies including 625 patients (372 EUS-GE and 253 SGE) were included. EUS-GE had lower pooled odds of technical success compared with SGE (OR 0.19, 95 % confidence interval [CI] 0.06–0.60, I 2 0 %). Among the technically successful cases, EUS-GE was superior in terms of clinical success (OR 4.73, 95 % CI 1.83–12.25, I 2 18 %), lower overall AE (OR 0.20, 95 % CI 0.10–0.37, I 2 39 %), and shorter procedure time (SMD –2.4, 95 % CI –4.1, –0.75, I 2 95 %) and post-procedure LOS (SMD –0.49, 95 % CI –0.94, –0.03, I 2 78%). Rates of severe AE (0.89, 95 % CI 0.11–7.36, I 2 67 %) and recurrence (OR 0.49, 95 % CI 0.18–1.38, I 2 49 %) were comparable. Conclusions Our results suggest EUS-GE is a promising alternative to SGE due to its superior clinical success, overall safety, and efficiency. With further evolution EUS-GE could become the intervention of choice in GOO.

show abstract

EUS-guided gastroenterostomy vs. surgical gastrojejunostomy and enteral stenting for malignant gastric outlet obstruction: a meta-analysis

et al. 2023

View full text Add to dashboard Cite

Background: Malignant gastric outlet obstruction (MGOO) is traditionally treated with surgical gastrojejunostomy (SGJ), which is effective but associated with high rates of morbidity, or endoscopic stenting (ES), which is less invasive but associated with significant risk of stent dysfunction and need for reintervention. Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) provides a robust bypass without the invasiveness of surgery. Methods: We performed a systematic review and meta-analysis comparing EUS-GE to SGJ and ES for MGOO. Electronic databases were searched from inception through February 2022. A meta-analysis was performed with results reported as odds ratios (ORs) with 95% confidence intervals (CIs) using random effects models. Primary outcomes included clinical success without recurrent GOO and adverse events. Results: Sixteen studies involving 1541 patients were included. EUS-GE was associated with higher clinical success without recurrent GOO compared to ES or SGJ [OR: 2.60, 95% CI:1.58; 4.28] and compared to ES alone [OR: 5.08, 95% CI: 3.42; 7.55], but yielded no significant difference compared to SGJ alone [OR: 1.94, 95% CI: 0.97; 3.88]. Adverse event rates were significantly lower for EUS-GE compared to ES or SGJ grouped together [OR: 0.34, 95% CI: 0.20; 0.58], or SGJ alone [OR: 0.17, 95% CI: 0.10; 0.30] but were not significant different versus ES alone [OR: 0.57, 95% CI: 0.29; 1.14]. Conclusion: EUS-GE provides the most successful approach to treating MGOO, exhibiting a lower risk of recurrent obstruction compared to ES, and fewer adverse events compared to SGJ.

show abstract

Su1286 ENDOSCOPIC ULTRASOUND-GUIDED GASTROJEJUNOSTOMY IS SUPERIOR TO DUODENAL SELF EXPANDABLE METAL STENT FOR PALLITAIVE TREATMENT OF MALIGNANT GASTRIC OUTLET OBSTRUCTTION: A COMPARATIVE CASE CONTROL STUDY

Cited by 7 publications

References 0 publications

EUS-guided gastroenterostomy versus enteral stenting for gastric outlet obstruction: Systematic review and meta-analysis

EUS-guided gastroenterostomy versus enteral stenting for gastric outlet obstruction: Systematic review and meta-analysis

EUS-guided gastroenterostomy versus surgical gastroenterostomy for the management of gastric outlet obstruction: a systematic review and meta-analysis

EUS-guided gastroenterostomy vs. surgical gastrojejunostomy and enteral stenting for malignant gastric outlet obstruction: a meta-analysis

Contact Info

Product

Resources

About