Patency of endoscopic ultrasound-guided gastroenterostomy in the treatment of malignant gastric outlet obstruction
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 E...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Georg Thieme Verlag KG
2020-08-01
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| Series: | Endoscopy International Open |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/a-1214-5659 |
| _version_ | 1819171989019951104 |
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| author | Janine B. Kastelijn Leon M.G. Moons Francisco J. Garcia-Alonso Manuel Pérez-Miranda Viliam Masaryk Uwe Will Ilaria Tarantino Hendrik M. van Dullemen Rina Bijlsma Jan-Werner Poley Matthijs P. Schwartz Frank P. Vleggaar |
| author_facet | Janine B. Kastelijn Leon M.G. Moons Francisco J. Garcia-Alonso Manuel Pérez-Miranda Viliam Masaryk Uwe Will Ilaria Tarantino Hendrik M. van Dullemen Rina Bijlsma Jan-Werner Poley Matthijs P. Schwartz Frank P. Vleggaar |
| author_sort | Janine B. Kastelijn |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-22T20:00:03Z |
| format | Article |
| id | doaj.art-7d80853ec969444d989eba67491bed21 |
| institution | Directory Open Access Journal |
| issn | 2364-3722 2196-9736 |
| language | English |
| last_indexed | 2024-12-22T20:00:03Z |
| publishDate | 2020-08-01 |
| publisher | Georg Thieme Verlag KG |
| record_format | Article |
| series | Endoscopy International Open |
| spelling | doaj.art-7d80853ec969444d989eba67491bed212022-12-21T18:14:17ZengGeorg Thieme Verlag KGEndoscopy International Open2364-37222196-97362020-08-010809E1194E120110.1055/a-1214-5659Patency of endoscopic ultrasound-guided gastroenterostomy in the treatment of malignant gastric outlet obstructionJanine B. Kastelijn0Leon M.G. Moons1Francisco J. Garcia-Alonso2Manuel Pérez-Miranda3Viliam Masaryk4Uwe Will5Ilaria Tarantino6Hendrik M. van Dullemen7Rina Bijlsma8Jan-Werner Poley9Matthijs P. Schwartz10Frank P. Vleggaar11Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The NetherlandsDepartment of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The NetherlandsDepartment of Gastroenterology and Hepatology, Hospital Universitario Rio Hortega, Valladolid, SpainDepartment of Gastroenterology and Hepatology, Hospital Universitario Rio Hortega, Valladolid, SpainDepartment of Gastroenterology and General Internal Medicine, SRH Wald-Klinikum, Gera, GermanyDepartment of Gastroenterology and General Internal Medicine, SRH Wald-Klinikum, Gera, GermanyGastroenterology and Endoscopy Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IsMeTT), Palermo, ItalyDepartment of Gastroenterology and Hepatology, University Medical Center Groningen, Groningen, The NetherlandsDepartment of Gastroenterology and Hepatology, Martini Hospital Groningen, Groningen, The NetherlandsDepartment of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The NetherlandsDepartment of Gastroenterology and Hepatology, Meander Medical Center, Amersfoort, The NetherlandsDepartment of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The NetherlandsBackground 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.http://www.thieme-connect.de/DOI/DOI?10.1055/a-1214-5659 |
| spellingShingle | Janine B. Kastelijn Leon M.G. Moons Francisco J. Garcia-Alonso Manuel Pérez-Miranda Viliam Masaryk Uwe Will Ilaria Tarantino Hendrik M. van Dullemen Rina Bijlsma Jan-Werner Poley Matthijs P. Schwartz Frank P. Vleggaar Patency of endoscopic ultrasound-guided gastroenterostomy in the treatment of malignant gastric outlet obstruction Endoscopy International Open |
| title | Patency of endoscopic ultrasound-guided gastroenterostomy in the treatment of malignant gastric outlet obstruction |
| title_full | Patency of endoscopic ultrasound-guided gastroenterostomy in the treatment of malignant gastric outlet obstruction |
| title_fullStr | Patency of endoscopic ultrasound-guided gastroenterostomy in the treatment of malignant gastric outlet obstruction |
| title_full_unstemmed | Patency of endoscopic ultrasound-guided gastroenterostomy in the treatment of malignant gastric outlet obstruction |
| title_short | Patency of endoscopic ultrasound-guided gastroenterostomy in the treatment of malignant gastric outlet obstruction |
| title_sort | patency of endoscopic ultrasound guided gastroenterostomy in the treatment of malignant gastric outlet obstruction |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/a-1214-5659 |
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