Endoscopy 2021; 53(S 01): S46
DOI: 10.1055/s-0041-1724368
Abstracts | ESGE Days
ESGE Days 2021 Oral presentations
Friday, 26 March 2021 12:00 – 12:45 EUS gastroenterostomy: A new gold standard for managing gastric outlet obstruction? Room 5

Enteral Stent Placement Versus Eus-Guided Gastroenterostomy for Palliation Of Malignant Gastric Outlet Obstruction: a Comparative Systematic Review and Meta-Analysis

MB Boghossian
1   Hospital das Clínicas, University of São Paulo School of Medicine, Gastrointestinal Endoscopy Unit, São Paulo, Brazil
,
MP Funari
1   Hospital das Clínicas, University of São Paulo School of Medicine, Gastrointestinal Endoscopy Unit, São Paulo, Brazil
,
DTH de Moura
1   Hospital das Clínicas, University of São Paulo School of Medicine, Gastrointestinal Endoscopy Unit, São Paulo, Brazil
,
TR McCarty
2   Harvard Medical School - Brigham and Women´s Hospital, Division of Gastroenterology, Hepatology and Endoscopy, Boston, United States
,
VMT Sagae
1   Hospital das Clínicas, University of São Paulo School of Medicine, Gastrointestinal Endoscopy Unit, São Paulo, Brazil
,
YI Chen
3   McGill University Health Centre, Division of Gastroenterology & Hepatology, Montreal, Canada
,
PJO Mendieta
1   Hospital das Clínicas, University of São Paulo School of Medicine, Gastrointestinal Endoscopy Unit, São Paulo, Brazil
,
FLP Neto
1   Hospital das Clínicas, University of São Paulo School of Medicine, Gastrointestinal Endoscopy Unit, São Paulo, Brazil
,
IB Ribeiro
1   Hospital das Clínicas, University of São Paulo School of Medicine, Gastrointestinal Endoscopy Unit, São Paulo, Brazil
,
S Cheng
1   Hospital das Clínicas, University of São Paulo School of Medicine, Gastrointestinal Endoscopy Unit, São Paulo, Brazil
,
WM Bernardo
1   Hospital das Clínicas, University of São Paulo School of Medicine, Gastrointestinal Endoscopy Unit, São Paulo, Brazil
,
EGH de Moura
1   Hospital das Clínicas, University of São Paulo School of Medicine, Gastrointestinal Endoscopy Unit, São Paulo, Brazil
› Institutsangaben
 
 

    Aims Malignant gastric outlet obstruction (GOO) is associated with significant morbidity and decreased quality of life. Therefore, effective palliative treatment is critically important. This the first systematic review and meta-analysis to compare enteral stenting (ES) versus endoscopic ultrasound-guided gastroenterostomy (EUS-GE) for palliation of malignant GOO in terms of efficacy and safety.

    Methods Searches were performed on MEDLINE, Central Cochrane, EMBASE, LILACS, and gray literature with no restrictions regarding the year of publication or language, to identify studies comparing ES versus EUS-GE for palliation of malignant GOO. Evaluated outcomes were: technical success, clinical success, length of hospital stay, severe adverse events, stent obstruction, stent obstruction due to tumor growth, symptom recurrence and re-intervention, and 30-day all-cause mortality.

    Results Three studies with a total of 242 patients were included. The EUS-GE group demonstrated higher clinical success (RD -0.14, CI -0.25,- 0.03; P = 0.01), less severe adverse events (RD 0.39, CI 0.18–0.82; P = 0.01), lower rates of stent obstruction (RD -0,2, CI -0,29,-0,12; P < 0.00001), stent obstruction due to tumor growth (RD -0,14, CI -0,21,-0,06; P 0.0002), and symptom recurrence and re-intervention (RD -0.20, CI -0.31,-0.08; P = 0.0009). There was no statistical difference between the groups regarding technical success, length of hospital stay, and 30-day all-cause mortality. The results are summarized in [Table 1].

    Tab. 1

    Synthesis of results for each outcome (EUS-GE x ES).

    OUTCOMES

    OVERALL ANALYSIS (RESPECTIVELY)

    Technical success, and clinical success

    RD = 0.01 (95 % CI: -0.06, 0.04; P = 0.68); RD = 0.14, (95 % CI -0.25,- 0.03; P = 0.01)

    Length of hospital stay, and severe adverse events

    RD = 1.42 (95 % CI: -0.31; 3.14; P = 0.11;); RD = 0.39, (95 % CI 0.18–0.82; P = 0.01)

    Stent obstruction, and stent obstruction due to tumor growth

    RD = -0,20, (95 % CI -0,29,-0,12; P = < 0.00001); RD = -0,14, (95 % CI -0,21,-0,06; P = 0.0002)

    Symptom recurrence and re-intervention, and 30-day all-cause mortality

    RD = -0.20, (95 % CI -0.31,-0.08; P = 0.0009); RD = 0.22, (95 % CI 0.03, 1.71; P = 0.15)

    Conclusions EUS-GE is superior to ES for malignant GOO palliation regarding clinical success, symptom recurrence and re-intervention, severe adverse events, stent obstruction, and stent obstruction due to tumor growth.

    Citation: Boghossian MB, Funari MP, de Moura DTH et al. OP109 ENTERAL STENT PLACEMENT VERSUS EUS-GUIDED GASTROENTEROSTOMY FOR PALLIATION OF MALIGNANT GASTRIC OUTLET OBSTRUCTION: A COMPARATIVE SYSTEMATIC REVIEW AND META-ANALYSIS. Endoscopy 2021; 53: S46.


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    Publikationsverlauf

    Artikel online veröffentlicht:
    19. März 2021

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