Double anchor lock fixing method to prevent stent displacement in endoscopic ultrasound-guided gastroenterostomy: a porcine study.
Double anchor lock (DAL)
Endoscopic ultrasound-guided gastroenterostomy (EUS-GE)
Gastric outlet obstruction (GOO)
Stent displacement
Journal
Surgical endoscopy
ISSN: 1432-2218
Titre abrégé: Surg Endosc
Pays: Germany
ID NLM: 8806653
Informations de publication
Date de publication:
07 2022
07 2022
Historique:
received:
21
09
2020
accepted:
19
10
2021
pubmed:
4
12
2021
medline:
7
6
2022
entrez:
3
12
2021
Statut:
ppublish
Résumé
Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) is widely used in patients with gastric outlet obstruction (GOO). Recurrence of obstruction symptoms caused by stent migration is the major reason for reintervention in EUS-GE. To solve this problem, we proposed developing a double anchor lock (DAL) fixing stent method for EUS-GE. The safety and efficacy of the DAL fixing stent method were evaluated in this study. Sixteen Bama miniature pigs were randomly divided into an experimental group (n = 8) and a control group (n = 8). A gastric outlet obstruction model was established for all the pigs. The experimental group was treated with the DAL fixing stent method for EUS-GE, while the control group was treated with EUS-GE. Three-month stent migration rate, remission rate of GOO, re-occlusion intervention rate, weight change, and incidence of procedure-related complications of EUS-GE were analyzed and estimated in the two groups. EUS-GE was successfully completed in every subject in both groups. Symptoms of digestive tract obstruction can be relieved in all animals. The stent existence rate in the 3 months was higher in the experimental group than in the control group (87.5% vs. 12.5%, P = 0.012). Except for one animal in the experimental group in which there was pneumoperitoneum due to a stent insertion failure, no animal experienced bleeding or perforation. The DAL fixing stent method, which can effectively prevent stent migration, is safe and simple. EUS-GE can effectively relieve the symptoms of digestive tract obstruction.
Sections du résumé
BACKGROUND
Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) is widely used in patients with gastric outlet obstruction (GOO). Recurrence of obstruction symptoms caused by stent migration is the major reason for reintervention in EUS-GE. To solve this problem, we proposed developing a double anchor lock (DAL) fixing stent method for EUS-GE. The safety and efficacy of the DAL fixing stent method were evaluated in this study.
METHODS
Sixteen Bama miniature pigs were randomly divided into an experimental group (n = 8) and a control group (n = 8). A gastric outlet obstruction model was established for all the pigs. The experimental group was treated with the DAL fixing stent method for EUS-GE, while the control group was treated with EUS-GE. Three-month stent migration rate, remission rate of GOO, re-occlusion intervention rate, weight change, and incidence of procedure-related complications of EUS-GE were analyzed and estimated in the two groups.
RESULTS
EUS-GE was successfully completed in every subject in both groups. Symptoms of digestive tract obstruction can be relieved in all animals. The stent existence rate in the 3 months was higher in the experimental group than in the control group (87.5% vs. 12.5%, P = 0.012). Except for one animal in the experimental group in which there was pneumoperitoneum due to a stent insertion failure, no animal experienced bleeding or perforation.
CONCLUSION
The DAL fixing stent method, which can effectively prevent stent migration, is safe and simple. EUS-GE can effectively relieve the symptoms of digestive tract obstruction.
Identifiants
pubmed: 34859303
doi: 10.1007/s00464-021-08834-y
pii: 10.1007/s00464-021-08834-y
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
4854-4861Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Références
James T, Grimm IS, Baron TH (2019) 894 Eus-guided gastroenteric anastomosis as a bridge to definitive treatment in benign gastric outlet obstruction. Gastrointest Endosc 91(6):AB118
doi: 10.1016/j.gie.2019.04.128
Khashab MA, Bukhari M, Baron TH, Nieto J, El Zein M, Chen Y-I (2017) 269 International multicenter comparative trial of endoscopic ultrasonography guided gastroenterostomy versus surgical gastrojejunostomy for the treatment of malignant gastric outlet obstruction. Endosc Int Open 5(4):E275–E281
doi: 10.1055/s-0043-101695
Kawakami H, Kubota Y, Ban T (2019) Antegrade stenting combined with hepaticogastrostomy using a 5.4-fr novel ultra-slim metallic stent and dedicated stent under eus guidance (with video). Endosc Ultrasound 8:352–353
doi: 10.4103/eus.eus_40_19
Itoi T, Ishii K, Tanaka R, Umeda J, Tonozuka R (2015) Current status and perspective of endoscopic ultrasonography-guided gastrojejunostomy: endoscopic ultrasonography-guided double-balloon-occluded gastrojejunostomy (with videos). J Hepatobiliary Pancreat Sci 22(1):3–11
doi: 10.1002/jhbp.148
Dhaliwal AJS, Cormier I, Jhand AS, Rangray R, Singh S (2018) Efficacy of endoscopic ultrasonography-guided gastroenterostomy (eus-ge) in gastric outlet obstruction (goo): a systematic review and meta-analysis: 809. Am J Gastroenterol 113(Supplement):S449–S450
doi: 10.14309/00000434-201810001-00809
Kumbhari V, Azola A, Tieu AH, Ngamruengphong S, El Zein MH, Khashab M (2015) 895 Eus-guided gastrojejunostomy for management of complete gastric outlet obstruction. Gastrointest Endosc 81(5):AB179
doi: 10.1016/j.gie.2015.03.1256
Ge PS, Young JY, Dong W, Thompson CC (2019) Eus-guided gastroenterostomy versus enteral stent placement for palliation of malignant gastric outlet obstruction. Surg Endosc 33:3404–3411
doi: 10.1007/s00464-018-06636-3
Tyberg A, Perez-Miranda M, Sanchez-Ocaa R, Peas I, Carlos DLS, Shah J et al (2016) Endoscopic ultrasound-guided gastrojejunostomy with a lumen-apposing metal stent: a multicenter, international experience. Endosc Int Open 4(03):E276–E281
doi: 10.1055/s-0042-101789
Binmoeller K, Shah J (2012) Endoscopic ultrasound-guided gastroenterostomy using novel tools designed for transluminal therapy: a porcine study. Endoscopy 44(05):499–503
doi: 10.1055/s-0032-1309382
Kerdsirichairat T, Irani S, Yang J, Brewer Gutierrez O, Moran R, Sanaei O et al (2019) Durability and long-term outcomes of direct eus-guided gastroenterostomy using lumen-apposing metal stents for gastric outlet obstruction. Endosc Int Open 07(02):E144–E150
doi: 10.1055/a-0799-9939
Wang G, Liu X, Wang S, Ge N, Sun S (2019) Endoscopic ultrasound-guided gastroenterostomy: a promising alternative to surgery. J Transl Intern Med 7(3):93–99
doi: 10.2478/jtim-2019-0021
Khashab MA, Baron TH et al (2015) Eus-guided gastroenterostomy: a new promising technique in evolution. Gastrointest Endosc 81(5):1234–1236
doi: 10.1016/j.gie.2014.12.053
Iqbal U, Khara HS, Hu Y, Kumar V, Tufail K, Confer B, Diehl DL (2020) EUS-guided gastroenterostomy for the management of gastric outlet obstruction: a systematic review and meta-analysis. Endosc Ultrasound 9(1):16–23
doi: 10.4103/eus.eus_70_19
Tringali A (2019) Endoscopic management of gastric outlet obstruction disease. Ann Gastroenterol 32(4):330–337
pubmed: 31263354
pmcid: 6595925
Fritscher-Ravens A, Mosse CA, Mills TN, Mukherjee D, Swain P (2002) A through-the-scope device for suturing and tissue approximation under eus control. Gastrointest Endosc 56(5):737–742
doi: 10.1016/S0016-5107(02)70130-2
Irani S, Itoi T, Baron TH, Khashab M (2020) Eus-guided gastroenterostomy: techniques from east to west. VideoGIE 5(2):48–50
doi: 10.1016/j.vgie.2019.10.007
Barbara B, Vipin G, Frank DC (2019) Therapeutic EUS: new tools, new devices, new applications. Endosc Ultrasound 8(6):370–381
doi: 10.4103/eus.eus_39_19
Rimbas M, Larghi A, Costamagna G (2017) Endoscopic ultrasound-guided gastroenterostomy: are we ready for prime time? Endosc Ultrasound 6(4):235
doi: 10.4103/eus.eus_47_17
Khashab MA, Kumbhari V, Grimm IS, Ngamruengphong S, Aguila G, El Zein M, Kalloo AN, Baron TH (2015) EUS-guided gastroenterostomy: the first U.S. clinical experience (with video). Gastrointest Endosc 82(5):932–938
doi: 10.1016/j.gie.2015.06.017
Irani S, Baron TH, Itoi T, Khashab MA (2017) Endoscopic gastroenterostomy: techniques and review. Curr Opin Gastroenterol 33(5):320–329
doi: 10.1097/MOG.0000000000000389
Chen YI, Itoi T, Baron TH, Nieto J, Haito-Chavez Y, Grimm IS, Ismail A, Ngamruengphong S, Bukhari M, Hajiyeva G, Alawad AS, Kumbhari V, Khashab MA (2017) EUS-guided gastroenterostomy is comparable to enteral stenting with fewer re-interventions in malignant gastric outlet obstruction. Surg Endosc 31(7):2946–2952
doi: 10.1007/s00464-016-5311-1
Cazacu IM, Singh BS, Saftoiu A, Bhutani MS (2019) Recent developments in hepatopancreatobiliary EUS. Endosc Ultrasound 8(3):146–150
doi: 10.4103/eus.eus_20_19
Prashant K, Amy T, Kumta NA, Monica G, Kunal K, Sharaiha RZ, Michel K (2015) EUS-directed transgastric ERCP for Roux-en-Y gastric bypass anatomy: a minimally invasive approach. Gastrointest Endosc 82(3):560–565
doi: 10.1016/j.gie.2015.03.1913
Paik WH, Park DH (2019) Outcomes and limitations: EUS-guided hepaticogastrostomy. Endosc Ultrasound 8:S44–S49
doi: 10.4103/eus.eus_51_19
Nonthikorn T, Ali TA, Pradermchai K, Phontep A, Wiriyaporn R, Patpong N, Krit K, Peerapol W, Rungsun R, Pinit K (2019) Walled-off peripancreatic fluid collections in asian population: paradigm shift from surgical and percutaneous to endoscopic drainage. J Transl Int Med 7(4):170–177
doi: 10.2478/jtim-2019-0032