Rai Praveer, Kumar Pankaj, Goel Amit, Singh Thakur Prashant, Sharma Malay
Department of Gastroenterology Sanjay Gandhi Postgraduate Institute of Medical Sciences Lucknow India.
Department of Gastroenterology Aryavrat Hospital Meerut India.
DEN Open. 2023 Jan 30;3(1):e210. doi: 10.1002/deo2.210. eCollection 2023 Apr.
Endoscopic ultrasound-guided gastrojejunostomy (EUS-GJ) is a therapeutic option for patients with gastric outlet obstruction (GOO), which provides long-term luminal patency without the risk of tumor ingrowth and/or overgrowth and avoids surgical morbidity. The goal of this study was to assess technical success, clinical success, and adverse events associated with a nasojejunal tube-assisted EUS- GJ technique.
This was a retrospective study conducted at a single tertiary care center. The nasojejunal tube (14F) was used to perform the EUS-GJ (device-assisted method). During the study period, consecutive GOO patients who underwent EUS-GJ between August 2018 and December 2021 were included. Technical success was defined as adequate positioning and deployment of the stent. The patient's ability to tolerate a normal oral diet without vomiting was defined as clinical success.
Thirty patients underwent EUS-GJ during this study period. Twenty-six patients had malignant GOO, while four had a benign obstruction. EUS-GJ was successfully performed in 29 patients, and technical success was 96.67% (29/30). Nasojejunal tube-assisted EUS-GJ technique was used in all patients. Clinical success was achieved in all patients who had technical success (29/29, 100%). The adverse events rate was 6.6%. During the procedure, the median procedure time was 25 min (interquartile range 15-42.5), and the average hospitalization was 4.4 days. Normal meals were tolerated by all patients. After 210 days of median follow-up (range 5-880 days), no recurrence of symptoms was observed.
The nasojejunal tube-assisted EUS-GJ is a safe and effective technique to treat GOO symptoms.
内镜超声引导下胃空肠吻合术（EUS-GJ）是胃出口梗阻（GOO）患者的一种治疗选择，它能提供长期的管腔通畅，且无肿瘤向内生长和/或过度生长的风险，还能避免手术并发症。本研究的目的是评估与鼻空肠管辅助EUS-GJ技术相关的技术成功率、临床成功率和不良事件。
这是一项在单一三级医疗中心进行的回顾性研究。使用鼻空肠管（14F）进行EUS-GJ（器械辅助法）。在研究期间，纳入了2018年8月至2021年12月期间连续接受EUS-GJ的GOO患者。技术成功定义为支架的正确定位和放置。患者能够耐受正常口服饮食且不呕吐被定义为临床成功。
在本研究期间，30例患者接受了EUS-GJ。26例患者为恶性GOO，4例为良性梗阻。29例患者成功进行了EUS-GJ，技术成功率为96.67%（29/30）。所有患者均采用鼻空肠管辅助EUS-GJ技术。所有技术成功的患者均取得了临床成功（29/29，100%）。不良事件发生率为6.6%。手术过程中，中位手术时间为25分钟（四分位间距15 - 42.5），平均住院时间为4.4天。所有患者均能耐受正常饮食。中位随访210天（范围5 - 880天）后，未观察到症状复发。
鼻空肠管辅助EUS-GJ是一种治疗GOO症状的安全有效的技术。
