PMID- 34569611
OWN - NLM
STAT- MEDLINE
DCOM- 20220630
LR  - 20220823
IS  - 1438-8812 (Electronic)
IS  - 0013-726X (Linking)
VI  - 54
IP  - 7
DP  - 2022 Jul
TI  - Clinical and technical outcomes of patients undergoing endoscopic 
      ultrasound-guided gastroenterostomy using 20-mm vs. 15-mm lumen-apposing metal 
      stents.
PG  - 680-687
LID - 10.1055/a-1654-6914 [doi]
AB  - BACKGROUND: Most studies on endoscopic ultrasound (EUS)-guided gastroenterostomy 
      (EUS-GE) for palliation of malignant gastric outlet obstruction (GOO) utilized a 
      15-mm lumen-apposing metal stent (LAMS). More recently, a 20-mm LAMS has become 
      available. This study aimed to compare rates of technical and clinical success 
      and adverse events (AEs) in patients undergoing EUS-GE using a 20-mm vs. 15-mm 
      LAMS. METHODS: Patients who underwent EUS-GE with 15-mm or 20-mm LAMS for 
      malignant GOO during the period from January 2018 to October 2020 were included. 
      The primary outcome was clinical success, defined as an increase in the gastric 
      outlet obstruction score (GOOS) by at least 1 point during follow-up. Secondary 
      outcomes were technical success, maximum tolerated diet, re-intervention rate, 
      and rate/severity of AEs. RESULTS: 267 patients (mean age 67 years, 43 % women) 
      with malignant GOO from 19 centers underwent EUS-GE. Clinical success rates were 
      similar for the 15-mm and 20-mm stents (89.2 % [95 %CI 84.2 %-94.2 %] vs. 84.1 % 
      [77.4%-90.6 %], respectively). However, a significantly higher proportion of 
      patients in the 20-mm group tolerated a soft solid/complete diet at the end of 
      follow-up (91.2 % [84.4 %-95.7 %] vs. 81.2 % [73.9 %-87.2 %], P = 0.04). Overall, 
      AEs occurred in 33 patients (12.4 % [8.4 %-16.3 %]), with similar rates for 15-mm 
      and 20-mm stents (12.8 % [7.5 %-18.2 %] vs. 11.8 % [6 %-17.6 %]), including 
      incidence of severe/fatal AEs (2 % [0.4 %-5.8 %] vs. 3.4 % [0.9 %-8.4 %]). 
      CONCLUSIONS: The 20-mm and 15-mm LAMS show similar safety and efficacy for 
      patients undergoing EUS-GE for malignant GOO. The 20-mm LAMS allows a more 
      advanced diet and is, thus preferred for EUS-GE.
CI  - Thieme. All rights reserved.
FAU - Bejjani, Michael
AU  - Bejjani M
AUID- ORCID: 0000-0001-5580-1145
AD  - Division of Gastroenterology and Hepatology, Johns Hopkins Hospital, Maryland, 
      USA.
FAU - Ghandour, Bachir
AU  - Ghandour B
AUID- ORCID: 0000-0002-7303-7504
AD  - Division of Gastroenterology and Hepatology, Johns Hopkins Hospital, Maryland, 
      USA.
FAU - Subtil, Jose Carlos
AU  - Subtil JC
AD  - Clinica Universidad de Navarra, Pamplona, Navarra, Spain.
FAU - Martinez-Moreno, Belen
AU  - Martinez-Moreno B
AD  - Endoscopy Unit, Hospital General Universitario de Alicante, Alicante, Spain.
FAU - Sharaiha, Reem Z
AU  - Sharaiha RZ
AUID- ORCID: 0000-0002-3235-6904
AD  - Weill Cornell Medicine, New York, New York State, United States.
FAU - Watson, Rabindra R
AU  - Watson RR
AD  - California Pacific Medical Center, San Francisco, California, United States.
FAU - Kowalski, Thomas E
AU  - Kowalski TE
AD  - Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States.
FAU - Benias, Petros C
AU  - Benias PC
AD  - Zucker School of Medicine at Hofstra/Northwell, Long Island Jewish Medical 
      Center, New Hyde Park, New York, United States.
FAU - Huggett, Matthew T
AU  - Huggett MT
AD  - Leeds Teaching Hospitals NHS Trust, Leeds, Leeds, United Kingdom.
FAU - Weber, Tobias
AU  - Weber T
AD  - University Hospital Augsburg, Augsburg, Bayern, Germany.
FAU - D'Souza, Lionel S
AU  - D'Souza LS
AD  - Stony Brook University Hospital, Stony Brook, New York, United States.
FAU - Anderloni, Andrea
AU  - Anderloni A
AD  - Division of Gastroenterology and Digestive Endoscopy, Department of 
      Gastroenterology, IRCCS Humanitas Research Hospital, Milan, Italy.
FAU - Lajin, Michael
AU  - Lajin M
AUID- ORCID: 0000-0001-7376-3461
AD  - Sharp Grossmont Hospital, La Mesa, California, United States.
FAU - Khara, Harshit S
AU  - Khara HS
AUID- ORCID: 0000-0003-2850-625X
AD  - Geisinger Medical Center, Danville, Pennsylvania, United States.
FAU - Pham, Khanh Do-Cong
AU  - Pham KD
AUID- ORCID: 0000-0002-6476-1680
AD  - Haukeland University Hospital, Bergen, Norway.
FAU - Pleskow, Douglas
AU  - Pleskow D
AUID- ORCID: 0000-0003-0092-9496
AD  - Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States.
FAU - Fabbri, Carlo
AU  - Fabbri C
AD  - Gastroenterology and Digestive Endoscopy Unit, Forli-Cesena Hospitals, AUSL 
      Romagna, Romagna, Italy.
FAU - Nieto, Jose M
AU  - Nieto JM
AD  - Borland Groover Clinic, Jacksonville, Florida, United States.
FAU - Kumta, Nikhil A
AU  - Kumta NA
AD  - Icahn School of Medicine at Mount Sinai, New York, New York State, United States.
FAU - Pawa, Rishi
AU  - Pawa R
AD  - Wake Forest University School of Medicine, Winston-Salem, North Carolina, United 
      States.
FAU - Jovani, Manol
AU  - Jovani M
AD  - Division of Gastroenterology and Hepatology, Johns Hopkins Hospital, Maryland, 
      USA.
FAU - Khashab, Mouen A
AU  - Khashab MA
AD  - Division of Gastroenterology and Hepatology, Johns Hopkins Hospital, Maryland, 
      USA.
CN  - EUS-GE Study Group
LA  - eng
PT  - Journal Article
DEP - 20220114
PL  - Germany
TA  - Endoscopy
JT  - Endoscopy
JID - 0215166
SB  - IM
EIN - Endoscopy. 2022 Mar 16;:. PMID: 35297027
MH  - Aged
MH  - Endosonography/adverse effects
MH  - Female
MH  - *Gastric Outlet Obstruction/etiology/surgery
MH  - *Gastroenterostomy/adverse effects
MH  - Humans
MH  - Male
MH  - Stents/adverse effects
MH  - Ultrasonography, Interventional/adverse effects
COIS- A. Anderloni is a consultant for Boston Scientific, Medtronic and Olympus. J.R. 
      Aparicio is a consultant for Boston Scientific. J.M. Buscaglia is a consultant 
      for Abbvie. B. Confer is a consultant for Boston Scientific. D.L. Diehl is a 
      consultant for Boston Scientific. C.J. DiMaio is a consultant for Boston 
      Scientific, Covidien, and SafeHeal; and a speaker for AbbVie, Mauna Kea, and 
      STERIS. A. Fugazza is a consultant for Boston Scientific and Olympus. M.T. 
      Huggett is a consultant for Boston Scientific, Olympus America, and Cook Medical. 
      M.A. Khashab is a consultant for Boston Scientific, Olympus, Medtronic, GI 
      Supply, MicroTech, and Apollo. H.S. Khara is a consultant for Boston Scientific. 
      T.E. Kowalski is a consultant for Boston Scientific and Medtronic. N.A. Kumta is 
      a consultant for Boston Scientific, Apollo Endosurgery, Intuitive Surgery, 
      Medtronic, and Olympus. D. Loren is a consultant for Boston Scientific, Olympus, 
      and Pinnacle Biologics; and receives research support from Medtronic. J.M. Nieto 
      is a consultant for Boston Scientific. B. Paranandi is a consultant for Boston 
      Scientific and Olympus America. K. D-C. Pham is a consultant for Boston 
      Scientific; he is a speaker for Boston Scientific, Cook Medical, Olympus America 
      and Taewoong Medical; and he is on on the advisory board of Ambu. D.K. Pleskow is 
      a consultant for Boston Scientific, Olympus America, and FujiFilm. D.V. Sejpal is 
      a consultant for Boston Scientific and Olympus America. R.Z. Sharaiha is a 
      consultant for Boston Scientific, Cook Medical, Olympus, and Lumendi. A.J. 
      Trindade is a consultant for Pentax Medical and Olympus America. R.R. Watson is a 
      consultant for Boston Scientific. The remaining authors declare that they have no 
      conflict of interest.
FIR - Peralta, Sandra
IR  - Peralta S
IRAD- Clinica Universidad de Navarra, Pamplona, Navarra, Spain.
FIR - Aparicio, Jose Ramon
IR  - Aparicio JR
IRAD- Endoscopy Unit, Hospital General Universitario de Alicante, Alicante, Spain.
FIR - Westerveld, Donevan
IR  - Westerveld D
IRAD- Weill Cornell Medicine, New York, New York State, United States.
FIR - Bernabe, Jona
IR  - Bernabe J
IRAD- California Pacific Medical Center, San Francisco, California, United States.
FIR - Hamerski, Chris
IR  - Hamerski C
IRAD- California Pacific Medical Center, San Francisco, California, United States.
FIR - Nett, Andrew
IR  - Nett A
IRAD- California Pacific Medical Center, San Francisco, California, United States.
FIR - Binmoeller, Kenneth
IR  - Binmoeller K
IRAD- California Pacific Medical Center, San Francisco, California, United States.
FIR - Loren, David
IR  - Loren D
IRAD- Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States.
FIR - Schlachterman, Alexander
IR  - Schlachterman A
IRAD- Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States.
FIR - Kumar, Anand
IR  - Kumar A
IRAD- Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States.
FIR - Chiang, Austin
IR  - Chiang A
IRAD- Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States.
FIR - Bashir, Muhammad
IR  - Bashir M
IRAD- Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States.
FIR - Holmes, Ian
IR  - Holmes I
IRAD- Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States.
FIR - Trindade, Arvind J
IR  - Trindade AJ
IRAD- Zucker School of Medicine at Hofstra/Northwell, Long Island Jewish Medical 
      Center, New Hyde Park, New York, United States.
FIR - Sejpal, Divysh V
IR  - Sejpal DV
IRAD- Zucker School of Medicine at Hofstra/Northwell, Long Island Jewish Medical 
      Center, New Hyde Park, New York, United States.
FIR - Paranandi, Bharat
IR  - Paranandi B
IRAD- Leeds Teaching Hospitals NHS Trust, Leeds, Leeds, United Kingdom.
FIR - Messmann, Helmut
IR  - Messmann H
IRAD- University Hospital Augsburg, Augsburg, Bayern, Germany.
FIR - Buscaglia, Jonathan M
IR  - Buscaglia JM
IRAD- Stony Brook University Hospital, Stony Brook, New York, United States.
FIR - Fugazza, Alessandro
IR  - Fugazza A
IRAD- Division of Gastroenterology and Digestive Endoscopy, Department of 
      Gastroenterology, IRCCS Humanitas Research Hospital, Milan, Italy.
FIR - Iqbal, Umair
IR  - Iqbal U
IRAD- Geisinger Medical Center, Danville, Pennsylvania, United States.
FIR - Confer, Bradley
IR  - Confer B
IRAD- Geisinger Medical Center, Danville, Pennsylvania, United States.
FIR - Diehl, David L
IR  - Diehl DL
IRAD- Geisinger Medical Center, Danville, Pennsylvania, United States.
FIR - Alrajhi, Saad
IR  - Alrajhi S
IRAD- Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States.
FIR - Binda, Cecilia
IR  - Binda C
IRAD- Gastroenterology and Digestive Endoscopy Unit, Forli-Cesena Hospitals, AUSL 
      Romagna, Romagna, Italy.
FIR - DiMaio, Christopher J
IR  - DiMaio CJ
IRAD- Icahn School of Medicine at Mount Sinai, New York, New York State, United States.
FIR - Pawa, Swati
IR  - Pawa S
IRAD- Wake Forest University School of Medicine, Winston-Salem, North Carolina, United 
      States.
FIR - Sanaei, Omid
IR  - Sanaei O
IRAD- Division of Gastroenterology and Hepatology, Johns Hopkins Hospital, Maryland, 
      USA.
FIR - Mony, Shruti
IR  - Mony S
IRAD- Division of Gastroenterology and Hepatology, Johns Hopkins Hospital, Maryland, 
      USA.
EDAT- 2021/09/28 06:00
MHDA- 2022/07/01 06:00
CRDT- 2021/09/27 08:59
PHST- 2021/09/27 00:00 [aheadofprint]
PHST- 2021/09/28 06:00 [pubmed]
PHST- 2022/07/01 06:00 [medline]
PHST- 2021/09/27 08:59 [entrez]
AID - 10.1055/a-1654-6914 [doi]
PST - ppublish
SO  - Endoscopy. 2022 Jul;54(7):680-687. doi: 10.1055/a-1654-6914. Epub 2022 Jan 14.