PMID- 37593104
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230823
IS  - 2364-3722 (Print)
IS  - 2196-9736 (Electronic)
IS  - 2196-9736 (Linking)
VI  - 11
IP  - 7
DP  - 2023 Jul
TI  - EUS-guided gastroenterostomy vs. surgical gastrojejunostomy and enteral stenting 
      for malignant gastric outlet obstruction: a meta-analysis.
PG  - E660-E672
LID - 10.1055/a-2098-2570 [doi]
AB  - Background and study aims Malignant gastric outlet obstruction (MGOO) is 
      traditionally treated with surgical gastrojejunostomy (SGJ), which is effective 
      but associated with high rates of morbidity, or endoscopic stenting (ES), which 
      is less invasive but associated with significant risk of stent dysfunction and 
      need for reintervention. Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) 
      provides a robust bypass without the invasiveness of surgery. Methods We 
      performed a systematic review and meta-analysis comparing EUS-GE to SGJ and ES 
      for MGOO. Electronic databases were searched from inception through February 
      2022. A meta-analysis was performed with results reported as odds ratios (ORs) 
      with 95% confidence intervals (CIs) using random effects models. Primary outcomes 
      included clinical success without recurrent GOO and adverse events (AEs). Results 
      Sixteen studies involving 1541 patients were included. EUS-GE was associated with 
      higher clinical success without recurrent GOO compared to ES or SGJ [OR 2.60, 95% 
      CI1.58-4.28] and compared to ES alone [OR 5.08, 95% CI 3.42-7.55], but yielded no 
      significant difference compared to SGJ alone [OR 1.94, 95% CI 0.97-3.88]. AE 
      rates were significantly lower for EUS-GE compared to ES or SGJ grouped together 
      [OR 0.34, 95% CI 0.20-0.58], or SGJ alone [OR 0.17, 95% CI 0.10-0.30] but were 
      not significant different versus ES alone [OR 0.57, 95% CI 0.29-1.14]. 
      Conclusions EUS-GE is the most successful approach to treating MGOO, exhibiting a 
      lower risk of recurrent obstruction compared to ES, and fewer AEs compared to 
      SGJ.
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 commercial purposes, or adapted, 
      remixed, transformed or built upon. 
      (https://creativecommons.org/licenses/by-nc-nd/4.0/).
FAU - Miller, Corey
AU  - Miller C
AD  - Division of Gastroenterology, Department of Medicine, Jewish General Hospital, 
      Montreal, Canada. RINGGOLD: 5621
AD  - Division of Experimental Medicine, Department of Medicine, McGill University 
      Faculty of Medicine and Health Sciences, Montreal, Canada. RINGGOLD: 12367
FAU - Benchaya, Joshua A
AU  - Benchaya JA
AD  - Faculty of Medicine, McGill University, Montreal, Canada. RINGGOLD: 5620
AD  - Division of Gastroenterology, Department of Medicine, Jewish General Hospital, 
      Montreal, Canada. RINGGOLD: 5621
FAU - Martel, Myriam
AU  - Martel M
AD  - Research Institute of the McGill University Health Center, McGill University 
      Health Centre, Montreal, Canada. RINGGOLD: 54473
FAU - Barkun, Alan
AU  - Barkun A
AD  - Division of Gastroenterology and Hepatology, McGill University Health Centre, 
      Montreal, Canada. RINGGOLD: 54473
FAU - Wyse, Jonathan M
AU  - Wyse JM
AD  - Division of Gastroenterology, Department of Medicine, Jewish General Hospital, 
      Montreal, Canada. RINGGOLD: 5621
FAU - Ferri, Lorenzo
AU  - Ferri L
AD  - Surgery, McGill University Health Centre, Montreal, Canada. RINGGOLD: 54473
FAU - Chen, Yen-I
AU  - Chen YI
AD  - Division of Gastroenterology and Hepatology, McGill University Health Centre, 
      Montreal, Canada. RINGGOLD: 54473
AD  - Division of Experimental Medicine, Department of Medicine, McGill University 
      Faculty of Medicine and Health Sciences, Montreal, Canada. RINGGOLD: 12367
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20230726
PL  - Germany
TA  - Endosc Int Open
JT  - Endoscopy international open
JID - 101639919
PMC - PMC10431974
COIS- Conflict of Interest Alan Barkun is a consultant for Olympus Inc. Yen-I Chen is a 
      consultant for Boston Scientific Inc. and president of Chess Medical. The 
      remaining authors disclose no conflicts.
EDAT- 2023/08/18 06:42
MHDA- 2023/08/18 06:43
PMCR- 2023/07/01
CRDT- 2023/08/18 03:47
PHST- 2022/12/09 00:00 [received]
PHST- 2023/04/21 00:00 [accepted]
PHST- 2023/08/18 06:43 [medline]
PHST- 2023/08/18 06:42 [pubmed]
PHST- 2023/08/18 03:47 [entrez]
PHST- 2023/07/01 00:00 [pmc-release]
AID - EIO-2022-12-2904-REV [pii]
AID - 10.1055/a-2098-2570 [doi]
PST - epublish
SO  - Endosc Int Open. 2023 Jul 26;11(7):E660-E672. doi: 10.1055/a-2098-2570. 
      eCollection 2023 Jul.