Patency of endoscopic ultrasound-guided gastroenterostomy in the treatment of malignant gastric outlet obstruction
Background and study aims Endoscopic ultrasoundguided 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 followup 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 EUSGE in clinical practice.
|Persistent URL||dx.doi.org/10.1055/a-1214-5659, hdl.handle.net/1765/130485|
|Journal||Endoscopy International Open|
Kastelijn, J.B., Moons, L.M., Garcia-Alonso, F.J., Perez-Miranda, M., Masaryk, V., Will, U., … Vleggaar, FP. (2020). Patency of endoscopic ultrasound-guided gastroenterostomy in the treatment of malignant gastric outlet obstruction. Endoscopy International Open, 08(09), E1194–E1201. doi:10.1055/a-1214-5659