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DOI: 10.1055/a-1765-4035
EUS-guided gastroenterostomy versus surgical gastroenterostomy for the management of gastric outlet obstruction: a systematic review and meta-analysis
Abstract
Background and study aims Surgical gastroenterostomy (SGE) has been the mainstay treatment for gastric outlet obstruction (GOO). The emergence of endoscopic ultrasound-guided gastroenterostomy (EUS-GE) presents a less invasive alternative for palliation of GOO. We conducted a comprehensive review and meta-analysis to compare the effectiveness and safety of EUS-GE compared to SGE.
Methods Multiple electronic databases and conference proceedings up to April 2021 were searched to identify studies that reported on safety and effectiveness of EUS-GE in comparison to SGE. Pooled odds ratios (ORs) of technical success, clinical success, adverse events (AE) and recurrence, and pooled standardized mean difference (SMD) of procedure time and post-procedure length of stay (LOS) were calculated. Study heterogeneity was assessed using I 2 and Cochran Q statistics.
Results Seven studies including 625 patients (372 EUS-GE and 253 SGE) were included. EUS-GE had lower pooled odds of technical success compared with SGE (OR 0.19, 95 % confidence interval [CI] 0.06–0.60, I 2 0 %). Among the technically successful cases, EUS-GE was superior in terms of clinical success (OR 4.73, 95 % CI 1.83–12.25, I 2 18 %), lower overall AE (OR 0.20, 95 % CI 0.10–0.37, I 2 39 %), and shorter procedure time (SMD –2.4, 95 % CI –4.1, –0.75, I 2 95 %) and post-procedure LOS (SMD –0.49, 95 % CI –0.94, –0.03, I 2 78%). Rates of severe AE (0.89, 95 % CI 0.11–7.36, I 2 67 %) and recurrence (OR 0.49, 95 % CI 0.18–1.38, I 2 49 %) were comparable.
Conclusions Our results suggest EUS-GE is a promising alternative to SGE due to its superior clinical success, overall safety, and efficiency. With further evolution EUS-GE could become the intervention of choice in GOO.
Publikationsverlauf
Eingereicht: 20. Juli 2021
Angenommen nach Revision: 25. Oktober 2021
Artikel online veröffentlicht:
14. April 2022
© 2022. 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/)
Georg Thieme Verlag KG
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References
- 1 Chowdhury A, Dhali GK, Banerjee PK. Etiology of gastric outlet obstruction. Am J Gastroenterol 1996; 91: 1679
- 2 Johnson CD. Gastric outlet obstruction malignant until proved otherwise. Am J Gastroenterol 1995; 90: 1740
- 3 Takeno A, Takiguchi S, Fujita J. et al. Clinical outcome and indications for palliative gastrojejunostomy in unresectable advanced gastric cancer: multi-institutional retrospective analysis. Ann Surg Oncol 2013; 20: 3527-3533
- 4 Bahra M, Jacob D. Surgical palliation of advanced pancreatic cancer. Recent Results Cancer Res 2008; 177: 111-120
- 5 Khashab M, Alawad AS, Shin EJ. et al. Enteral stenting versus gastrojejunostomy for palliation of malignant gastric outlet obstruction. Surg Endosc 2013; 27: 2068-2075
- 6 Jeurnink SM, Steyerberg EW, van Hooft JE. et al. Surgical gastrojejunostomy or endoscopic stent placement for the palliation of malignant gastric outlet obstruction (SUSTENT study): a multicenter randomized trial. Gastrointest Endosc 2010; 71: 490-499
- 7 Storm AC, Ryou M. Advances in the endoscopic management of gastric outflow disorders. Curr Opin Gastroenterol 2017; 33: 455-460
- 8 No JH, Kim SW, Lim CH. et al. Long-term outcome of palliative therapy for gastric outlet obstruction caused by unresectable gastric cancer in patients with good performance status: endoscopic stenting versus surgery. Gastrointest Endosc 2013; 78: 55-62
- 9 Itoi T, Baron TH, Khashab MA. et al. Technical review of endoscopic ultrasonography-guided gastroenterostomy in 2017. Dig Endosc 2017; 29: 495-502
- 10 Khashab MA, Baron TH, Binmoeller KF. et al. EUS-guided gastroenterostomy: a new promising technique in evolution. Gastrointest Endosc 2015; 81: 1234-1236
- 11 Binmoeller KF, Shah JN. Endoscopic ultrasound-guided gastroenterostomy using novel tools designed for transluminal therapy: a porcine study. Endoscopy 2012; 44: 499-503
- 12 Tyberg A, Perez-Miranda M, Sanchez-Ocana R. et al. Endoscopic ultrasound-guided gastrojejunostomy with a lumen-apposing metal stent: a multicenter, international experience. Endosc Int Open 2016; 4: E276-E281
- 13 Irani S, Baron TH, Itoi T. et al. Endoscopic gastroenterostomy: techniques and review. Curr Opin Gastroenterol 2017; 33: 320-329
- 14 Carbajo AY, Kahaleh M, Tyberg A. Clinical review of EUS-guided gastroenterostomy (EUS-GE). J Clin Gastroenterol 2020; 54: 1-7
- 15 Kerdsirichairat T, Irani S, Yang J. et al. Durability and long-term outcomes of direct EUS-guided gastroenterostomy using lumen-apposing metal stents for gastric outlet obstruction. Endosc Int Open 2019; 7: E144-E50
- 16 Iqbal U, Khara HS, Hu Y. et al. EUS-guided gastroenterostomy for the management of gastric outlet obstruction: A systematic review and meta-analysis. Endosc Ultrasound 2020; 9: 16-23
- 17 Itoi T, Ishii K, Ikeuchi N. et al. Prospective evaluation of endoscopic ultrasonography-guided double-balloon-occluded gastrojejunostomy bypass (EPASS) for malignant gastric outlet obstruction. Gut 2016; 65: 193-195
- 18 Khashab MA, Kumbhari V, Grimm IS. et al. EUS-guided gastroenterostomy: the first U.S. clinical experience (with video). Gastrointest Endosc 2015; 82: 932-938
- 19 Chen YI, Itoi T, Baron TH. et al. EUS-guided gastroenterostomy is comparable to enteral stenting with fewer re-interventions in malignant gastric outlet obstruction. Surg Endosc 2017; 31: 2946-2952
- 20 Chandan S, Khan SR, Mohan BP. et al. EUS-guided gastroenterostomy versus enteral stenting for gastric outlet obstruction: Systematic review and meta-analysis. Endosc Int Open 2021; 9: E496-E504
- 21 Itoi T, Itokawa F, Uraoka T. et al. Novel EUS-guided gastrojejunostomy technique using a new double-balloon enteric tube and lumen-apposing metal stent (with videos). Gastrointest Endosc 2013; 78: 934-939
- 22 Bondi G, Bazarbashi AN, Abbas AM. et al. Su1269 Endoscopic gastroenterostomy versus surgical gastrojejunostomy for the treatment of gastric outlet obstruction in patients with peritoneal carcinomatosis: a retrospective comparative study. Gastrointest Endosc 2020; 91: AB303
- 23 Widmer JL, Winner M, Allendorf J. et al. Su1154 Single center comparative study of endoscopic gastrojejunostomy versus surgical gastrojejunostomy for malignant gastric outlet obstruction. Gastrointest Endosc 2019; 89: AB291
- 24 Marya N, Jaruvongvanich V, Abu Dayyeh BK. et al. Su1268 A multicenter international study comparing clinical outcomes of eus-guided gastrojejunostomy, surgical gastrojejunostomy, and enteral stenting for patients with gastric outlet obstruction. Gastrointest Endosc 2020; 91: AB302-AB303
- 25 Khashab MA, Bukhari M, Baron TH. et al. International multicenter comparative trial of endoscopic ultrasonography-guided gastroenterostomy versus surgical gastrojejunostomy for the treatment of malignant gastric outlet obstruction. Endosc Int Open 2017; 5: E275-E81
- 26 Perez-Miranda M, Tyberg A, Poletto D. et al. EUS-guided gastrojejunostomy versus laparoscopic gastrojejunostomy: an international collaborative study. J Clin Gastroenterol 2017; 51: 896-899
- 27 Kouanda A, Binmoeller K, Hamerski C. et al. Endoscopic ultrasound-guided gastroenterostomy versus open surgical gastrojejunostomy: clinical outcomes and cost effectiveness analysis. Surg Endosc 2021; 35: 7058-7067
- 28 Bronswijk M, Vanella G, van Malenstein H. et al. Laparoscopic versus EUS-guided gastroenterostomy for gastric outlet obstruction: an international multicenter propensity score-matched comparison (with video). Gastrointest Endosc 2021; 94: 526-536.e2
- 29 Moher D, Liberati A, Tetzlaff J. et al. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med 2009; 6: e1000097
- 30 Stroup DF, Berlin JA, Morton SC. et al. for the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) Group. Meta-analysis of Observational Studies in Epidemiology. A Proposal for Reporting. . JAMA 2000; 283: 2008-2012
- 31 Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol 2010; 25: 603-605
- 32 Cotton PB, Eisen GM, Aabakken L. et al. A lexicon for endoscopic adverse events: report of an ASGE workshop. Gastrointest Endosc 2010; 71: 446-454
- 33 DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials 1986; 7: 177-188
- 34 Higgins JP, Thompson SG, Spiegelhalter DJ. A re-evaluation of random-effects meta-analysis. J R Stat Soc Ser A Stat Soc 2009; 172: 137-159
- 35 Higgins JP, Thompson SG, Deeks JJ. et al. Measuring inconsistency in meta-analyses. BMJ 2003; 327: 557-560
- 36 Wan X, Wang W, Liu J. et al. Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range. BMC Med Res Methodol 2014; 14: 135
- 37 Higgins JP, White IR, Wood AM. Imputation methods for missing outcome data in meta-analysis of clinical trials. Clin Trials 2008; 5: 225-239
- 38 Furukawa TA, Barbui C, Cipriani A. et al. Imputing missing standard deviations in meta-analyses can provide accurate results. J Clin Epidemiol 2006; 59: 7-10
- 39 Higgins JPT, Thomas J, Chandler J. et al. Cochrane Handbook for Systematic Reviews of Interventions. 2 ed. Chichester (UK): John Wiley & Sons; 2019
- 40 Bronswijk M, Vanella G, Van Malenstein H. et al. VDM. Laparoscopic or EUS-guided gastroenterostomy for gastric outlet obstruction: A propensity score matched analysis. United Europ Gastroenterol J 2020; 8: 804-805
- 41 Xu G, Shen Y, Lv Y. et al. Safety and efficacy of endoscopic ultrasound-guided gastroenterostomy using double balloon occlusion methods: a clinical retrospective study in 36 patients with malignant gastric outlet obstruction. Endosc Int Open 2020; 8: E1690-E1697
- 42 Kastelijn JB, Moons LMG, Garcia-Alonso FJ. et al. Patency of endoscopic ultrasound-guided gastroenterostomy in the treatment of malignant gastric outlet obstruction. Endosc Int Open 2020; 8: E1194-E201
- 43 Amateau SK, Lim CH, McDonald NM. et al. EUS-guided endoscopic gastrointestinal anastomosis with lumen-apposing metal stent: feasibility, safety, and efficacy. Obes Surg 2018; 28: 1445-1451
- 44 Kerdsirichairat T, Yang J, Gutierrez OIB. et al. Long-term outcomes of endoscopic ultrasound-guided gastroenterostomy using lumen-apposing metal stents for gastric outlet obstruction: A 4-year cohort. Gastrointest Endosc 2018; 87: AB320-AB1
- 45 Ge PS, Young JY, Dong W. et al. EUS-guided gastroenterostomy versus enteral stent placement for palliation of malignant gastric outlet obstruction. Surg Endosc 2019; 33: 3404-3411
- 46 Iqbal U, Berger A, Confer B. et al. Endoscopic ultrasound-guided gastroenterostomy vs. enteral stenting for treatment of gastric outlet obstruction: a retrospective review: 918. Am J Gastroenterol 2019; 114: S536-S537
- 47 Vazquez-Sequeiros E, Sanchez-Aldehuelo R, de Santiago ER. et al. Su1286 Endoscopic ultrasound-guided gastrojejunostomy is superior to duodenal self expandable metal stent for pallitaive treatment of malignant gastric outlet obstructtion: a comparative case control study. Gastrointest Endosc 2020; 91: AB312-AB313
- 48 Larghi A, Ibrahim M, Fuccio L. et al. Forward-viewing echoendoscope versus standard echoendoscope for endoscopic ultrasound-guided tissue acquisition of solid lesions: a randomized, multicenter study. Endoscopy 2019; 515: 444-451