International multicenter comparative trial of endoscopic ultrasonography-guided gastroenterostomy versus surgical gastrojejunostomy for the treatment of malignant gastric outlet obstruction
Background and study aims EUS-guided gastroenterostomy (EUS-GE) is a novel procedure that potentially offers long-lasting luminal patency without the risk of tumor ingrowth/overgrowth. This study compared the clinical success, technical success, adverse events (AEs), length of hospital stay (LOHS) a...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Georg Thieme Verlag KG
2017-04-01
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| Series: | Endoscopy International Open |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0043-101695 |
| _version_ | 1818061493349908480 |
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| author | Mouen A. Khashab Majidah Bukhari Todd H. Baron Jose Nieto Mohamad El Zein Yen-I Chen Yamile Haito Chavez Saowanee Ngamruengphong Ahmad S. Alawad Vivek Kumbhari Takao Itoi |
| author_facet | Mouen A. Khashab Majidah Bukhari Todd H. Baron Jose Nieto Mohamad El Zein Yen-I Chen Yamile Haito Chavez Saowanee Ngamruengphong Ahmad S. Alawad Vivek Kumbhari Takao Itoi |
| author_sort | Mouen A. Khashab |
| collection | DOAJ |
| description | Background and study aims EUS-guided gastroenterostomy (EUS-GE) is a novel procedure that potentially offers long-lasting luminal patency without the risk of tumor ingrowth/overgrowth. This study compared the clinical success, technical success, adverse events (AEs), length of hospital stay (LOHS) and symptom recurrence in EUS-GE versus SGJ.
Methods This was a multicenter international retrospective comparative study of EUS-GE and SGJ in patients with malignant gastric outlet obstruction (GOO) who underwent either EUS-GE or SGJ. EUS-GE was performed using lumen apposing metal stents.
Results A total of 93 patients with malignant GOO treated with either EUS-GE (n = 30) or SGJ (n = 63) were identified. Peritoneal carcinomatosis was present in 13 (43 %) patients in the EUS-GE group and 7 (11 %) patients in the SGJ group (P < 0.001). Although the technical success rate was significantly higher in the SGJ group as compared to the EUS-GE group (100 % vs. 87 %, P = 0.009), the clinical success rate was not different (90 % vs. 87 %, P = 0.18, OR 0.8, 95 %CI 0.44 – 7.07). The rate of AEs was lower in the EUS-GE group, but the difference was not statistically significant (16 % vs 25 %, P = 0.3). The mean LOHS was similar in the EUS-GE group compared to SGJ (P = 0.35). The rate of recurrent GOO was not different between the two groups (3 % vs. 14 %, P = 0.08). Similarly, the mean time to reintervention was similar (88 days vs. 121 days, P = 0.83).
Conclusions EUS-GE is associated with equivalent efficacy and safety as compared to surgical GJ. This is the first comparative trial between both techniques and suggests EUS-GE as a non-inferior but less invasive alter to surgery. |
| first_indexed | 2024-12-10T13:49:11Z |
| format | Article |
| id | doaj.art-f03211662b8b4c4ba283b372d32ba9dd |
| institution | Directory Open Access Journal |
| issn | 2364-3722 2196-9736 |
| language | English |
| last_indexed | 2024-12-10T13:49:11Z |
| publishDate | 2017-04-01 |
| publisher | Georg Thieme Verlag KG |
| record_format | Article |
| series | Endoscopy International Open |
| spelling | doaj.art-f03211662b8b4c4ba283b372d32ba9dd2022-12-22T01:46:19ZengGeorg Thieme Verlag KGEndoscopy International Open2364-37222196-97362017-04-010504E275E28110.1055/s-0043-101695International multicenter comparative trial of endoscopic ultrasonography-guided gastroenterostomy versus surgical gastrojejunostomy for the treatment of malignant gastric outlet obstructionMouen A. Khashab0Majidah Bukhari1Todd H. Baron2Jose Nieto3Mohamad El Zein4Yen-I Chen5Yamile Haito Chavez6Saowanee Ngamruengphong7Ahmad S. Alawad8Vivek Kumbhari9Takao Itoi10Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, United StatesDivision of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, United StatesDivision of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina, United StatesBorland-Groover Clinic, Jacksonville, Florida, United StatesDivision of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, United StatesDivision of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, United StatesDivision of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, United StatesDivision of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, United StatesDivision of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, United StatesDivision of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, United StatesDivision of Gastroenterology and Hepatology, Tokyo Medical University, Shinjuku-ku, Tokyo, JapanBackground and study aims EUS-guided gastroenterostomy (EUS-GE) is a novel procedure that potentially offers long-lasting luminal patency without the risk of tumor ingrowth/overgrowth. This study compared the clinical success, technical success, adverse events (AEs), length of hospital stay (LOHS) and symptom recurrence in EUS-GE versus SGJ. Methods This was a multicenter international retrospective comparative study of EUS-GE and SGJ in patients with malignant gastric outlet obstruction (GOO) who underwent either EUS-GE or SGJ. EUS-GE was performed using lumen apposing metal stents. Results A total of 93 patients with malignant GOO treated with either EUS-GE (n = 30) or SGJ (n = 63) were identified. Peritoneal carcinomatosis was present in 13 (43 %) patients in the EUS-GE group and 7 (11 %) patients in the SGJ group (P < 0.001). Although the technical success rate was significantly higher in the SGJ group as compared to the EUS-GE group (100 % vs. 87 %, P = 0.009), the clinical success rate was not different (90 % vs. 87 %, P = 0.18, OR 0.8, 95 %CI 0.44 – 7.07). The rate of AEs was lower in the EUS-GE group, but the difference was not statistically significant (16 % vs 25 %, P = 0.3). The mean LOHS was similar in the EUS-GE group compared to SGJ (P = 0.35). The rate of recurrent GOO was not different between the two groups (3 % vs. 14 %, P = 0.08). Similarly, the mean time to reintervention was similar (88 days vs. 121 days, P = 0.83). Conclusions EUS-GE is associated with equivalent efficacy and safety as compared to surgical GJ. This is the first comparative trial between both techniques and suggests EUS-GE as a non-inferior but less invasive alter to surgery.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0043-101695 |
| spellingShingle | Mouen A. Khashab Majidah Bukhari Todd H. Baron Jose Nieto Mohamad El Zein Yen-I Chen Yamile Haito Chavez Saowanee Ngamruengphong Ahmad S. Alawad Vivek Kumbhari Takao Itoi International multicenter comparative trial of endoscopic ultrasonography-guided gastroenterostomy versus surgical gastrojejunostomy for the treatment of malignant gastric outlet obstruction Endoscopy International Open |
| title | International multicenter comparative trial of endoscopic ultrasonography-guided gastroenterostomy versus surgical gastrojejunostomy for the treatment of malignant gastric outlet obstruction |
| title_full | International multicenter comparative trial of endoscopic ultrasonography-guided gastroenterostomy versus surgical gastrojejunostomy for the treatment of malignant gastric outlet obstruction |
| title_fullStr | International multicenter comparative trial of endoscopic ultrasonography-guided gastroenterostomy versus surgical gastrojejunostomy for the treatment of malignant gastric outlet obstruction |
| title_full_unstemmed | International multicenter comparative trial of endoscopic ultrasonography-guided gastroenterostomy versus surgical gastrojejunostomy for the treatment of malignant gastric outlet obstruction |
| title_short | International multicenter comparative trial of endoscopic ultrasonography-guided gastroenterostomy versus surgical gastrojejunostomy for the treatment of malignant gastric outlet obstruction |
| title_sort | international multicenter comparative trial of endoscopic ultrasonography guided gastroenterostomy versus surgical gastrojejunostomy for the treatment of malignant gastric outlet obstruction |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0043-101695 |
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