PMID- 31673620
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200930
IS  - 2364-3722 (Print)
IS  - 2196-9736 (Electronic)
IS  - 2196-9736 (Linking)
VI  - 7
IP  - 11
DP  - 2019 Nov
TI  - Efficacy and safety of EUS-guided gastroenterostomy for benign and malignant 
      gastric outlet obstruction: a systematic review and meta-analysis.
PG  - E1474-E1482
LID - 10.1055/a-0996-8178 [doi]
AB  - Background and study aims  Endoscopic ultrasound-guided gastroenterostomy 
      (EUS-GE) is a novel endoscopic procedure designed to facilitate sustained luminal 
      patency in patients with gastric outlet obstruction. The primary aim of this 
      study was to evaluate the efficacy and safety of EUS-GE for treatment of gastric 
      outlet obstruction. Methods  Searches of PubMed, EMBASE, Web of Science, and 
      Cochrane Library databases were performed through April 2019. Patients with 
      benign and malignant gastric outlet obstruction were included. Measured outcomes 
      included: immediate technical and clinical success as well as rate of serious 
      adverse events (AEs). Heterogeneity was assessed with Cochran Q test and I (2) 
      statistics. Publication bias was ascertained by funnel plot and Egger regression 
      testing. Results  A total of five studies (n = 199 patients; 45.73 % male) were 
      included in this study. Four retrospective studies and one prospective study were 
      analyzed. Mean age of patients that underwent the EUS-GE procedure was 
      64.52 +/- 1.37 years with a pooled mean follow-up period of 4.32 +/- 1.65 months. In 
      21 % of patients (n = 43), gastric outlet obstruction was due to benign causes. 
      Immediate technical success was 92.90 % (95 % CI; 88.26 - 95.79; I (2)  = 0.00 %) 
      and reported in all studies. The clinical success rate of EUS-GE was 90.11 % 
      (95 % CI; 84.64 - 93.44; I (2)  = 0.00 %). Serious AEs occurred in 5.61 % (95 % 
      CI; 2.87 - 10.67; I (2)  = 1.67 %) of cases and were related to peritonitis, 
      perforation, bleeding, and abdominal pain. Re-intervention rate was 11.43 % (95 % 
      CI; 7.29 - 17.46; I (2)  = 17.38 %). Conclusions  EUS-GE appears to provide an 
      effective and safe minimally invasive alternative for treatment of benign and 
      malignant gastric outlet obstruction.
FAU - McCarty, Thomas R
AU  - McCarty TR
AD  - Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's 
      Hospital, Boston, Massachusetts, United States.
AD  - Harvard Medical School, Boston, Massachusetts, United States.
FAU - Garg, Rajat
AU  - Garg R
AD  - Cleveland Clinic, Cleveland, Ohio, United States.
FAU - Thompson, Christopher C
AU  - Thompson CC
AD  - Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's 
      Hospital, Boston, Massachusetts, United States.
AD  - Harvard Medical School, Boston, Massachusetts, United States.
FAU - Rustagi, Tarun
AU  - Rustagi T
AD  - Division of Gastroenterology and Hepatology, University of New Mexico, 
      Albuquerque, New Mexico, United States.
LA  - eng
PT  - Journal Article
DEP - 20191023
PL  - Germany
TA  - Endosc Int Open
JT  - Endoscopy international open
JID - 101639919
PMC - PMC6811354
COIS- Competing interests Dr. Thompson is a consultant for Boston Scientific, Olympus, 
      and Apollo Endosurgery. Dr. Rustagi is a consultant for Boston Scientific and 
      Cook Endoscopy.
EDAT- 2019/11/02 06:00
MHDA- 2019/11/02 06:01
PMCR- 2019/11/01
CRDT- 2019/11/02 06:00
PHST- 2019/06/12 00:00 [received]
PHST- 2019/07/31 00:00 [accepted]
PHST- 2019/11/02 06:00 [entrez]
PHST- 2019/11/02 06:00 [pubmed]
PHST- 2019/11/02 06:01 [medline]
PHST- 2019/11/01 00:00 [pmc-release]
AID - 10.1055/a-0996-8178 [doi]
PST - ppublish
SO  - Endosc Int Open. 2019 Nov;7(11):E1474-E1482. doi: 10.1055/a-0996-8178. Epub 2019 
      Oct 23.