Endoscopic ultrasound-guided gastroenterostomy versus duodenal stenting for malignant gastric outlet obstruction: an international, multicenter, propensity score-matched comparison.
In: Endoscopy, Jg. 54 (2022-11-01), Heft 11, S. 1023-1031
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Zugriff:
Background: Endoscopic duodenal stenting is the current standard treatment for malignant gastric outlet obstruction (GOO) in patients with limited life expectancy. However, duodenal stenting is prone to stent dysfunction. Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) is a novel technique with potentially superior stent patency. We compared clinical success, safety, and stent dysfunction of EUS-GE and duodenal stenting in patients with malignant GOO using propensity score matching. Methods: This international, multicenter, retrospective study analyzed consecutive patients undergoing EUS-GE or duodenal stenting for GOO between 2015 and 2021 in three European centers. Primary outcomes were clinical success (GOO scoring system [GOOSS] ≥ 2) and stent dysfunction (GOOSS ≤ 1 after initial clinical success). A propensity score matching (1:1) analysis was performed using age, sex, underlying disease, disease stage, ascites, and peritoneal carcinomatosis as variables. Results: 214 patients underwent EUS-GE (n = 107) or duodenal stenting (n = 107). After propensity score matching, 176 patients were matched and compared. Technical success rates for EUS-GE and duodenal stenting were 94 % (95 %CI 89 %-99 %) vs. 98 % (95 %CI 95 %-100 %), respectively (P = 0.44). Clinical success rates were 91 % (95 %CI 85 %-97 %) vs. 75 % (95 %CI 66 %-84 %; P = 0.008). Stent dysfunction occurred in 1 % (95 %CI 0-4 %) vs. 26 % (95 %CI 15 %-37 %) of patients (P < 0.001). Adverse event rate was 10 % (95 %CI 4 %-17 %) vs. 21 % (95 %CI 12 %-29 %; P = 0.09). Conclusion: EUS-GE had higher clinical success and lower stent dysfunction, with similar safety, compared with duodenal stenting, suggesting that EUS-GE may be preferred over duodenal stenting in patients with malignant GOO. [ABSTRACT FROM AUTHOR]
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Endoscopic ultrasound-guided gastroenterostomy versus duodenal stenting for malignant gastric outlet obstruction: an international, multicenter, propensity score-matched comparison.
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Autor/in / Beteiligte Person: | van Wanrooij, Roy L. J. ; Vanella, Giuseppe ; Bronswijk, Michiel ; de Gooyer, Peter ; Laleman, Wim ; van Malenstein, Hannah ; Mandarino, Francesco Vito ; Dell'Anna, Giuseppe ; Fockens, Paul ; Arcidiacono, Paolo G. ; van der Merwe, Schalk W. ; Voermans, Rogier P. |
Zeitschrift: | Endoscopy, Jg. 54 (2022-11-01), Heft 11, S. 1023-1031 |
Veröffentlichung: | 2022 |
Medientyp: | academicJournal |
ISSN: | 0013-726X (print) |
DOI: | 10.1055/a-1782-7568 |
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