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Endoscopy 2025; 57(01): 77-82
DOI: 10.1055/a-2354-3352
Innovations and brief communications

Endoscopic ultrasound-guided entero-colostomy with lumen-apposing metal stent as a rescue treatment for malignant intestinal occlusion: a multicenter study

Benedetto Neri 
1   Therapeutic GI Endoscopy Unit, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
2   Department of Systems Medicine, Gastroenterology Unit, University ‘Tor Vergata’ of Rome, Rome, Italy
,
Serena Stigliano
1   Therapeutic GI Endoscopy Unit, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
,
Dario Biasutto
1   Therapeutic GI Endoscopy Unit, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
,
Nicolò Citterio
3   Therapeutic GI Endoscopy Unit, TherFondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
4   Gastroenterology Unit, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
,
Andrea Lisotti 
5   Gastroenterology Unit, Hospital of Imola, University of Bologna, Bologna, Italy
,
Pietro Fusaroli 
5   Gastroenterology Unit, Hospital of Imola, University of Bologna, Bologna, Italy
,
Benedetto Mangiavillano 
6   Gastrointestinal Endoscopy Unit, Humanitas Mater Domini, Castellanza, Italy – Humanitas University, Milan, Italy
,
Gianfranco Donatelli 
7   Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy
8   Department of Interventional Endoscopy and Endoscopic Surgery, Hopital Privé des Peupliers, Paris, France
,
Giuseppe Tonini
9   Department of Medical Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
,
Francesco Maria Di Matteo
1   Therapeutic GI Endoscopy Unit, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
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Einführung zu diesem Artikel:

Let’s appose our hands together and anastomose the digestive tract – that’s our destinyEndoscopy 2025; 57(01): 83-84
DOI: 10.1055/a-2416-4835

Abstract

Background Surgery is the first-choice treatment for malignant intestinal obstruction (MIO); however, many patients are deemed unfit for surgery. Endoscopic ultrasound-guided entero-colostomy (EUS-EC) with a lumen-apposing metal stent (LAMS) could represent a new treatment option.

Methods Consecutive patients undergoing EUS-EC for MIO from November 2021 to September 2023 at four European tertiary referral centers were retrospectively enrolled. Multidisciplinary meetings determined whether patients were unsuitable for surgery or colonic stent placement, or refused surgery. The primary outcome was technical success of EUS-EC and secondary outcomes were clinical outcome, safety, and hospital stay.

Results 12 patients were enrolled (median age 72.5 [range 42–85] years; 58.3% female). Colonic adenocarcinoma was the primary tumor in 75.0% of patients and 91.7% had stage IV disease. Technical success was 100%. No LAMS misdeployment or other procedural adverse events occurred; three patients (25.0%) had severe post-procedural complications. Clinical success was achieved in 10 patients (83.3%), with 5 (50.0%) resuming chemotherapy after the procedure. Median post-procedural hospital stay was 9 (1–20) days and median overall survival was 47.5 (2–270) days.

Conclusions EUS-EC was a feasible technique and could be considered a possible alternative to standard approaches for MIO in highly selected patients.

Supplementary Material



Publikationsverlauf

Eingereicht: 17. November 2023

Angenommen nach Revision: 26. Juni 2024

Accepted Manuscript online:
26. Juni 2024

Artikel online veröffentlicht:
14. August 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 

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