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

Benedetto Neri; Serena Stigliano; Dario Biasutto; Nicolò Citterio; Andrea Lisotti; Pietro Fusaroli; Benedetto Mangiavillano; Gianfranco Donatelli; Giuseppe Tonini; Francesco Maria Di Matteo

doi:10.1055/a-2354-3352

Endoscopy, Inhaltsverzeichnis

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

¹Therapeutic GI Endoscopy Unit, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy

²Department of Systems Medicine, Gastroenterology Unit, University ‘Tor Vergata’ of Rome, Rome, Italy

,

Serena Stigliano

¹Therapeutic GI Endoscopy Unit, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy

,

Dario Biasutto

¹Therapeutic GI Endoscopy Unit, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy

,

Nicolò Citterio

³Therapeutic GI Endoscopy Unit, TherFondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy

⁴Gastroenterology Unit, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy

,

Andrea Lisotti

⁵Gastroenterology Unit, Hospital of Imola, University of Bologna, Bologna, Italy

,

Pietro Fusaroli

⁵Gastroenterology Unit, Hospital of Imola, University of Bologna, Bologna, Italy

,

Benedetto Mangiavillano

⁶Gastrointestinal Endoscopy Unit, Humanitas Mater Domini, Castellanza, Italy – Humanitas University, Milan, Italy

,

Gianfranco Donatelli

⁷Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy

⁸Department of Interventional Endoscopy and Endoscopic Surgery, Hopital Privé des Peupliers, Paris, France

,

Giuseppe Tonini

⁹Department of Medical Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy

,

Francesco Maria Di Matteo

¹Therapeutic GI Endoscopy Unit, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy

› Institutsangaben

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.

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Referenzen

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