PMID- 27834024
OWN - NLM
STAT- MEDLINE
DCOM- 20180223
LR  - 20220318
IS  - 1432-2218 (Electronic)
IS  - 0930-2794 (Linking)
VI  - 31
IP  - 7
DP  - 2017 Jul
TI  - EUS-guided gastroenterostomy is comparable to enteral stenting with fewer 
      re-interventions in malignant gastric outlet obstruction.
PG  - 2946-2952
LID - 10.1007/s00464-016-5311-1 [doi]
AB  - BACKGROUND AND AIMS: Endoscopic enteral stenting (ES) in malignant gastric outlet 
      obstruction (GOO) is limited by high rates of stent obstruction. EUS-guided 
      gastroenterostomy (EUS-GE) is a novel procedure that potentially offers sustained 
      patency without tumor ingrowth/overgrowth. The aim of this study is to compare 
      EUS-GE with ES in terms of (1) symptom recurrence and need for re-intervention, 
      (2) technical success (proper stent positioning as determined via endoscopy and 
      fluoroscopy), (3) clinical success (ability to tolerate oral intake without 
      vomiting), and (4) procedure-related adverse events (AEs). METHODS: Multicenter 
      retrospective study of all consecutive patients who underwent either EUS-GE at 
      four centers between 2013 and 2015 or ES at one center between 2008 and 2010. 
      RESULTS: A total of 82 patients (mean age 66-years +/- 13.5 and 40.2% female) were 
      identified: 30 in EUS-GE and 52 in ES. Technical and clinical success was not 
      significantly different: 86.7% EUS-GE versus 94.2% ES (p = 0.2) and 83.3% EUS-GE 
      versus 67.3% ES (p = 0.12), respectively. Symptom recurrence and need for 
      re-intervention, however, was significantly lower in the EUS-GE group (4.0 vs. 
      28.6%, (p = 0.015). Post-procedure mean length of hospitalization was comparable 
      at 11.3 days +/- 6.6 for EUS-GE versus 9.5 days +/- 8.3 for ES (p = 0.3). Rates and 
      severity of AEs (as per the ASGE lexicon) were also similar (16.7 vs. 11.5%, 
      p = 0.5). On multivariable analysis, ES was independently associated with need 
      for re-intervention (OR 12.8, p = 0.027). CONCLUSION: EUS-GE may be ideal for 
      malignant GOO with comparable effectiveness and safety to ES while being 
      associated with fewer symptom recurrence and requirements for re-intervention.
FAU - Chen, Yen-I
AU  - Chen YI
AUID- ORCID: 0000-0001-5704-2226
AD  - Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, 
      Baltimore, MD, USA.
FAU - Itoi, Takao
AU  - Itoi T
AD  - Division of Gastroenterology and Hepatology, Tokyo Medical University, 
      Shinjuku-ku, Tokyo, Japan. itoi@tokyo-med.ac.jp.
FAU - Baron, Todd H
AU  - Baron TH
AD  - Division of Gastroenterology and Hepatology, University of North Carolina, Chapel 
      Hill, NC, USA.
FAU - Nieto, Jose
AU  - Nieto J
AD  - Borland-Groover Clinic, Jacksonville, FL, USA.
FAU - Haito-Chavez, Yamile
AU  - Haito-Chavez Y
AD  - Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, 
      Baltimore, MD, USA.
FAU - Grimm, Ian S
AU  - Grimm IS
AD  - Division of Gastroenterology and Hepatology, University of North Carolina, Chapel 
      Hill, NC, USA.
FAU - Ismail, Amr
AU  - Ismail A
AD  - Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, 
      Baltimore, MD, USA.
FAU - Ngamruengphong, Saowanee
AU  - Ngamruengphong S
AD  - Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, 
      Baltimore, MD, USA.
FAU - Bukhari, Majidah
AU  - Bukhari M
AD  - Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, 
      Baltimore, MD, USA.
FAU - Hajiyeva, Gulara
AU  - Hajiyeva G
AD  - Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, 
      Baltimore, MD, USA.
FAU - Alawad, Ahmad S
AU  - Alawad AS
AD  - Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, 
      Baltimore, MD, USA.
FAU - Kumbhari, Vivek
AU  - Kumbhari V
AD  - Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, 
      Baltimore, MD, USA.
FAU - Khashab, Mouen A
AU  - Khashab MA
AD  - Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, 
      Baltimore, MD, USA.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
DEP - 20161110
PL  - Germany
TA  - Surg Endosc
JT  - Surgical endoscopy
JID - 8806653
SB  - IM
EIN - Surg Endosc. 2017 Jul 17;:. PMID: 28717868
MH  - Adult
MH  - Aged
MH  - Digestive System Neoplasms/*complications
MH  - *Endosonography
MH  - Female
MH  - Follow-Up Studies
MH  - Gastric Outlet Obstruction/diagnostic imaging/etiology/*surgery
MH  - Gastroenterostomy/*methods
MH  - Gastroscopy/*methods
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Palliative Care/methods
MH  - Reoperation/statistics & numerical data
MH  - Retrospective Studies
MH  - *Stents
MH  - Treatment Outcome
MH  - Ultrasonography, Interventional/*methods
OTO - NOTNLM
OT  - Endoscopic ultrasound
OT  - Endoscopy
OT  - Gastric outlet obstruction
OT  - Stents
EDAT- 2016/11/12 06:00
MHDA- 2018/02/24 06:00
CRDT- 2016/11/12 06:00
PHST- 2016/09/01 00:00 [received]
PHST- 2016/10/25 00:00 [accepted]
PHST- 2016/11/12 06:00 [pubmed]
PHST- 2018/02/24 06:00 [medline]
PHST- 2016/11/12 06:00 [entrez]
AID - 10.1007/s00464-016-5311-1 [pii]
AID - 10.1007/s00464-016-5311-1 [doi]
PST - ppublish
SO  - Surg Endosc. 2017 Jul;31(7):2946-2952. doi: 10.1007/s00464-016-5311-1. Epub 2016 
      Nov 10.