The lumen-apposing metal stent (LAMS)-in-LAMS technique as an intraprocedural rescue treatment during endoscopic ultrasound-guided gastroenterostomy

Ligresti, Dario; Amata, Michele; Barresi, Luca; Granata, Antonino; Traina, Mario; Tarantino, Ilaria

doi:10.1055/a-0924-5408

Cited by 16 publications

(12 citation statements)

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“…All fatal AEs and most stent misplacements occurred in one center, early after the introduction of EUS-GE. EUS-GE technique has been refined over time (e. g. elimination of guidewire assistance, development of a technique to salvage initial failed placements) and more knowledge about the risks and pitfalls of performing EUS-GE became available [26]. Moreover, interventional endoscopists who began performing EUS-GE more recently may have more experience with LAMS, as it is more routinely used for other indications.…”

Section: Grading Of Adverse Eventsmentioning

confidence: 99%

Patency of endoscopic ultrasound-guided gastroenterostomy in the treatment of malignant gastric outlet obstruction

et al. 2020

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Background and study aims Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) with a lumen-apposing metal stent (LAMS) is a novel, minimally invasive technique in the palliative treatment of malignant gastric outlet obstruction (GOO). Several studies have demonstrated feasibility and safety of EUS-GE, but evidence on long-term durability is limited. The aim of this study was to evaluate patency of EUS-GE in treatment of malignant GOO. Patients and Methods An international multicenter study was performed in seven centers in four European countries. Patients who underwent EUS-GE with a LAMS between March 2015 and March 2019 for palliative treatment of symptomatic malignant GOO were included retrospectively. Our main outcome was recurrent obstruction due to LAMS dysfunction; other outcomes of interest were technical success, clinical success, adverse events (AEs), and survival. Results A total of 45 patients (mean age 69.9 ± 12.3 years and 48.9 % male) were included. Median duration of follow-up was 59 days (interquartile range [IQR] 41–128). Recurrent obstruction occurred in two patients (6.1 %), after 33 and 283 days of follow-up. Technical success was achieved in 39 patients (86.7 %). Clinical success was achieved in 33 patients (73.3 %). AEs occurred in 12 patients (26.7 %), of which five were fatal. Median overall survival was 57 days (IQR 32–114). Conclusions EUS-GE showed a low rate of recurrent obstruction. The relatively high number of fatal AEs underscores the importance of careful implementation of EUS-GE in clinical practice.

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Section: Grading Of Adverse Eventsmentioning

confidence: 99%

Patency of endoscopic ultrasound-guided gastroenterostomy in the treatment of malignant gastric outlet obstruction

et al. 2020

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“…gastroentorostomy, pancreatic fluid collection, gallbladder), but mainly with the use of the 10 × 10‐mm size and located in the gastric cavity. At the same time, a LAMS‐in‐LAMS technique, a new variant of the well‐known stent‐in‐stent technique, has recently been described in a few cases to remove the embedded covered metal stent 1‐5 …”

Section: Brief Explanationmentioning

confidence: 99%

Endoscopic ultrasound‐guided ostomy repermeabilization as a rescue technique to resolve a deeply buried lumen‐apposing stent

Izquierdo‐Romero

Bas‐Cutrina

Gornals

2020

Digestive Endoscopy

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“…[2] According to recent trials, EUS-GE leads to the recovery of oral intake in 90% of patients, without the risk of tumor ingrowth and/or overgrowth, and meanwhile avoiding the potential morbidity of surgery. [5,12, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26]…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Ultrasound-guided Gastroenterostomy: A Promising Alternative to Surgery

Wang

Xiang

Wang

et al. 2019

Journal of Translational Internal Medicine

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Recently, with the advancement of techniques, endoscopic ultrasound-guided therapies have shown distinct advantages, especially in relieving benign and malignant gastric outlet obstruction (GOO), as well as in postoperative pancreaticobiliary diseases. Herein, we present five currently used approaches in endoscopic ultrasound-guided gastroenterostomy (EUS-GE) using lumenapposing biflanged metal stents (LAMS), along with several examples of LAMS-based EUS treatment of pancreaticobiliary diseases. Compared with traditional treatment methods, EUS-guided procedures have – to some degree – shown higher success rates, both technical and clinical. Moreover, EUS-guided therapies reduce the risk of multiple surgical adverse events, including delayed gastric emptying, prolonged hospital stay, increased costs, and delay in cancer treatment. Particularly in terms of postoperative pancreaticobiliary diseases, EUS-guided therapy has assumed an essential role as a treatment option in cases where traditional methods are difficult to perform. Nevertheless, EUS-guided gastrointestinal procedures are still relatively new, with some clinical failures, and additional prospective clinical trials are warranted.

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The lumen-apposing metal stent (LAMS)-in-LAMS technique as an intraprocedural rescue treatment during endoscopic ultrasound-guided gastroenterostomy

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Cited by 16 publications

References 4 publications

Patency of endoscopic ultrasound-guided gastroenterostomy in the treatment of malignant gastric outlet obstruction

Patency of endoscopic ultrasound-guided gastroenterostomy in the treatment of malignant gastric outlet obstruction

Endoscopic ultrasound‐guided ostomy repermeabilization as a rescue technique to resolve a deeply buried lumen‐apposing stent

Endoscopic Ultrasound-guided Gastroenterostomy: A Promising Alternative to Surgery

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