PMID- 33655056
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231110
IS  - 2364-3722 (Print)
IS  - 2196-9736 (Electronic)
IS  - 2196-9736 (Linking)
VI  - 9
IP  - 3
DP  - 2021 Mar
TI  - EUS-guided gastroenterostomy versus enteral stenting for gastric outlet 
      obstruction: Systematic review and meta-analysis.
PG  - E496-E504
LID - 10.1055/a-1341-0788 [doi]
AB  - Background and study aims  Endoscopic and surgical techniques have been utilized 
      for palliation of gastric outlet obstruction (GOO). Enteral stenting (ES) is an 
      established technique with high clinical success and low morbidity rate. 
      Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) is a novel approach that 
      aims to provide sustained palliation of GOO. We conducted a comprehensive review 
      and meta-analysis to evaluate the effectiveness in terms of clinical and 
      technical success, as well as the safety profile of EUS-GE and ES. Methods  We 
      searched multiple databases from inception through July 2020 to identify studies 
      that reported on safety and effectiveness of EUS-GE in comparison to ES. Pooled 
      rates of technical success, clinical success, and adverse events (AEs) were 
      calculated. Study heterogeneity was assessed using I (2) % and 95 % confidence 
      interval. Results  Five studies including 659 patients were included in our final 
      analysis. Pooled rate of technical and clinical success for EUS-GE was 95.2 % (CI 
      87.2-.98.3, I (2)  = 42) and 93.3 % (CI 84.4-97.3, I (2)  = 59) while for ES it 
      was 96.9 % (CI 90.9-99, I (2)  = 64) and 85.6 % (CI 73-92.9, I (2)  = 85), 
      respectively. Pooled rate of re-intervention was significantly lower with EUS-GE 
      i. e. 4 % (CI 1.8-8.7, I (2)  = 35) compared to ES, where it was 23.6 % (CI 
      17.5-31, I (2)  = 35), p = 0.001 . Pooled rates of overall and major AEs were 
      comparable between the two techniques. Conclusion  EUS-GE is comparable in terms 
      of technical and clinical effectiveness and has a similar safety profile when 
      compared to ES for palliation of GOO.
CI  - The Author(s). This is an open access article published by Thieme under the terms 
      of the Creative Commons Attribution-NonDerivative-NonCommercial License, 
      permitting copying and reproduction so long as the original work is given 
      appropriate credit. Contents may not be used for commecial purposes, or adapted, 
      remixed, transformed or built upon. 
      (https://creativecommons.org/licenses/by-nc-nd/4.0/).
FAU - Chandan, Saurabh
AU  - Chandan S
AD  - Division of Gastroenterology, CHI Creighton University Medical Center, Omaha, 
      Nebraska, United States.
FAU - Khan, Shahab R
AU  - Khan SR
AD  - Section of Gastroenterology, Rush University Medical Center, Chicago, Illinois, 
      USA.
FAU - Mohan, Babu P
AU  - Mohan BP
AD  - Division of Gastroenterology and Hepatology, University of Utah School of 
      Medicine, Salt Lake City, Utah, United States.
FAU - Shah, Aun R
AU  - Shah AR
AD  - Gastroenterology and Hepatology, University of Nebraska Medical Center, Omaha, 
      Nebraska, Unites States.
FAU - Bilal, Mohammad
AU  - Bilal M
AD  - Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard 
      Medical School, Boston, Massachusetts, United States.
FAU - Ramai, Daryl
AU  - Ramai D
AD  - Internal Medicine, The Brooklyn Hospital Center, New York, United States.
FAU - Bhogal, Neil
AU  - Bhogal N
AD  - Gastroenterology and Hepatology, University of Nebraska Medical Center, Omaha, 
      Nebraska, Unites States.
FAU - Dhindsa, Banreet
AU  - Dhindsa B
AD  - Gastroenterology and Hepatology, University of Nebraska Medical Center, Omaha, 
      Nebraska, Unites States.
FAU - Kassab, Lena L
AU  - Kassab LL
AD  - Internal Medicine, Mayo Clinic, Rochester, Minnesota, United States.
FAU - Singh, Shailendra
AU  - Singh S
AD  - Department of Medicine, West Virginia University Charleston Division, Charleston, 
      West Virginia, United States.
FAU - Ponnada, Suresh
AU  - Ponnada S
AD  - Internal Medicine, Carilion Roanoke Memorial Hospital, Roanoke, Virginia, United 
      States.
FAU - Nguyen, Andrew K
AU  - Nguyen AK
AD  - Division of Gastroenterology and Hepatology, University of Utah School of 
      Medicine, Salt Lake City, Utah, United States.
FAU - McDonough, Stephanie
AU  - McDonough S
AD  - Division of Gastroenterology and Hepatology, University of Utah School of 
      Medicine, Salt Lake City, Utah, United States.
FAU - Adler, Douglas G
AU  - Adler DG
AD  - Division of Gastroenterology and Hepatology, University of Utah School of 
      Medicine, Salt Lake City, Utah, United States.
LA  - eng
PT  - Journal Article
DEP - 20210222
PL  - Germany
TA  - Endosc Int Open
JT  - Endoscopy international open
JID - 101639919
PMC - PMC7899789
COIS- Competing interests Dr. Adler is a consultant for Boston Scientific
EDAT- 2021/03/04 06:00
MHDA- 2021/03/04 06:01
PMCR- 2021/03/01
CRDT- 2021/03/03 05:48
PHST- 2020/09/18 00:00 [received]
PHST- 2020/11/27 00:00 [accepted]
PHST- 2021/03/03 05:48 [entrez]
PHST- 2021/03/04 06:00 [pubmed]
PHST- 2021/03/04 06:01 [medline]
PHST- 2021/03/01 00:00 [pmc-release]
AID - 10.1055/a-1341-0788 [doi]
PST - ppublish
SO  - Endosc Int Open. 2021 Mar;9(3):E496-E504. doi: 10.1055/a-1341-0788. Epub 2021 Feb 
      22.