Department of GastroenterologyEndoscopic Center, Shengjing Hospital of China Medical University, Sanhao street 36, Shenyang, 110004, Liaoning Province, China.
Surg Endosc. 2022 Jul;36(7):4854-4861. doi: 10.1007/s00464-021-08834-y. Epub 2021 Dec 2.
Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) is widely used in patients with gastric outlet obstruction (GOO). Recurrence of obstruction symptoms caused by stent migration is the major reason for reintervention in EUS-GE. To solve this problem, we proposed developing a double anchor lock (DAL) fixing stent method for EUS-GE. The safety and efficacy of the DAL fixing stent method were evaluated in this study.
Sixteen Bama miniature pigs were randomly divided into an experimental group (n = 8) and a control group (n = 8). A gastric outlet obstruction model was established for all the pigs. The experimental group was treated with the DAL fixing stent method for EUS-GE, while the control group was treated with EUS-GE. Three-month stent migration rate, remission rate of GOO, re-occlusion intervention rate, weight change, and incidence of procedure-related complications of EUS-GE were analyzed and estimated in the two groups.
EUS-GE was successfully completed in every subject in both groups. Symptoms of digestive tract obstruction can be relieved in all animals. The stent existence rate in the 3 months was higher in the experimental group than in the control group (87.5% vs. 12.5%, P = 0.012). Except for one animal in the experimental group in which there was pneumoperitoneum due to a stent insertion failure, no animal experienced bleeding or perforation.
The DAL fixing stent method, which can effectively prevent stent migration, is safe and simple. EUS-GE can effectively relieve the symptoms of digestive tract obstruction.
内镜超声引导下胃造口术（EUS-GE）广泛应用于胃出口梗阻（GOO）患者。支架迁移引起的梗阻症状复发是 EUS-GE 再次干预的主要原因。为了解决这个问题，我们提出了一种用于 EUS-GE 的双锚锁（DAL）固定支架方法。本研究评估了 DAL 固定支架方法的安全性和有效性。
将 16 头巴马小型猪随机分为实验组（n=8）和对照组（n=8）。所有猪均建立胃出口梗阻模型。实验组采用 DAL 固定支架方法进行 EUS-GE，对照组采用 EUS-GE。分析和评估两组 3 个月支架迁移率、GOO 缓解率、再闭塞干预率、体重变化和 EUS-GE 相关并发症发生率。
两组所有动物均成功完成 EUS-GE。所有动物的消化道梗阻症状均可缓解。实验组 3 个月内支架存在率高于对照组（87.5%比 12.5%，P=0.012）。实验组除 1 例因支架插入失败导致气腹外，无动物发生出血或穿孔。
DAL 固定支架方法可有效预防支架迁移，安全简单。EUS-GE 可有效缓解消化道梗阻症状。
