PMID- 28382326
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220409
IS  - 2364-3722 (Print)
IS  - 2196-9736 (Electronic)
IS  - 2196-9736 (Linking)
VI  - 5
IP  - 4
DP  - 2017 Apr
TI  - International multicenter comparative trial of endoscopic ultrasonography-guided 
      gastroenterostomy versus surgical gastrojejunostomy for the treatment of 
      malignant gastric outlet obstruction.
PG  - E275-E281
LID - 10.1055/s-0043-101695 [doi]
AB  - 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.
FAU - Khashab, Mouen A
AU  - Khashab MA
AD  - Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, 
      Baltimore, Maryland, United States.
FAU - Bukhari, Majidah
AU  - Bukhari M
AD  - Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, 
      Baltimore, Maryland, United States.
FAU - Baron, Todd H
AU  - Baron TH
AD  - Division of Gastroenterology and Hepatology, University of North Carolina, Chapel 
      Hill, North Carolina, United States.
FAU - Nieto, Jose
AU  - Nieto J
AD  - Borland-Groover Clinic, Jacksonville, Florida, United States.
FAU - El Zein, Mohamad
AU  - El Zein M
AD  - Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, 
      Baltimore, Maryland, United States.
FAU - Chen, Yen-I
AU  - Chen YI
AD  - Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, 
      Baltimore, Maryland, United States.
FAU - Chavez, Yamile Haito
AU  - Chavez YH
AD  - Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, 
      Baltimore, Maryland, United States.
FAU - Ngamruengphong, Saowanee
AU  - Ngamruengphong S
AD  - Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, 
      Baltimore, Maryland, United States.
FAU - Alawad, Ahmad S
AU  - Alawad AS
AD  - Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, 
      Baltimore, Maryland, United States.
FAU - Kumbhari, Vivek
AU  - Kumbhari V
AD  - Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, 
      Baltimore, Maryland, United States.
FAU - Itoi, Takao
AU  - Itoi T
AD  - Division of Gastroenterology and Hepatology, Tokyo Medical University, 
      Shinjuku-ku, Tokyo, Japan.
LA  - eng
PT  - Journal Article
PL  - Germany
TA  - Endosc Int Open
JT  - Endoscopy international open
JID - 101639919
PMC - PMC5378550
COIS- Competing interests Mouen Khashab is a consultant for Boston Scientific. Todd 
      Baron is a consultant for Boston Scientific. Jose Nieto is a consultant for 
      Boston Scientific. Takao Itoi is a consultant for Boston Scientific
EDAT- 2017/04/07 06:00
MHDA- 2017/04/07 06:01
PMCR- 2017/04/01
CRDT- 2017/04/07 06:00
PHST- 2017/04/07 06:00 [entrez]
PHST- 2017/04/07 06:00 [pubmed]
PHST- 2017/04/07 06:01 [medline]
PHST- 2017/04/01 00:00 [pmc-release]
AID - 10.1055/s-0043-101695 [doi]
PST - ppublish
SO  - Endosc Int Open. 2017 Apr;5(4):E275-E281. doi: 10.1055/s-0043-101695.