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CC BY-NC-ND 4.0 · Endosc Int Open 2023; 11(08): E735
DOI: 10.1055/a-2090-0685
Letter to the editor

Response to Canakis et al

Veeravich Jaruvongvanich
1   Gastroenterology, Queen's Medical Center, Honolulu, United States
,
Donna Maria Abboud 
2   Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, United States (Ringgold ID: RIN6915)
,
Rudy Mrad
3   Gastroenterology, Mayo Clinic, Rochester, United States (Ringgold ID: RIN6915)
,
Barham K. Abu Dayyeh
2   Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, United States (Ringgold ID: RIN6915)
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Letter to:

EUS Gastroenterostomy: Primetime for All?Endosc Int Open 2023; 11(06): E566-E567
DOI: 10.1055/a-2090-0533

We thank Drs. Canakis, Gilman, and Baron [1] for their comments regarding our recent article in Endoscopy International Open titled “Endoscopic ultrasound-guided gastroenterostomy for the management of gastric outlet obstruction: A large comparative study with long-term follow-up” [2].

They suggested performing a more focused comparison between laparoscopic surgical gastroenterostomy (SGE) and endoscopic ultrasound-guided gastroenterostomy (EUS-GE) as the laparoscopic surgical approach is the more preferred method that is associated with improved outcomes and decreased length of stay (LOS) than the open surgical approach.

In our study, 73 SGE patients consisted of 58 patients with a laparoscopic approach and 15 with an open approach. We performed a subgroup analysis to compare EUS-GE with laparoscopic SGE. The technical success was comparable between the two groups (EUS-GE 98.3% and laparoscopic SGE 100%, P = 0.31). The clinical success of EUS-GE was significantly higher than for laparoscopic SGE (98.3% vs. 93.1%, P = 0.03, respectively). The reintervention rate of EUS-GE was significantly lower than laparoscopic SGE (0.9% vs. 12.1%, P < 0.0001, respectively). The post-procedural LOS of the EUS-GE group was significantly shorter than the laparoscopic SGE group (median LOS: 2 days [IQR 1–3 days] vs. 4 days [IQR 2–7 days], P < 0.0001, respectively). Lastly, the overall adverse event (AE) rate for EUS-GE was significantly lower than for laparoscopic SGE (8.6% vs. 24.1%, P=0.0006, respectively).

Based on these subgroup analyses, the EUS-GE had comparable technical success, higher clinical success, and a lower reintervention rate, shorter LOS, and fewer AEs compared to laparoscopic SGE.



Publication History

Article published online:
07 August 2023

© 2023. 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/).

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