Department of Gastroenterology, Robert Wood Johnson University Hospital, New Brunswick, NJ.
Yale University School of Medicine, New Haven, CT.
J Clin Gastroenterol. 2024 Jul 1;58(6):570-573. doi: 10.1097/MCG.0000000000001903.
Endoscopic ultrasound (EUS)-guided gastroenterostomy (EUS-GE) is a minimally invasive therapy for patients with gastric outlet obstruction without the risks of surgical bypass and the limited long-term efficacy of enteral self-expanding metal stent placement. However, due to its novelty, there is a lack of significant data comparing long-term outcomes of patients with EUS-GE, based on the underlying disease. In this study, we compare outcomes of EUS-GE on benign versus malignant indications.
Consecutive patients from 12 international, tertiary care centers who underwent EUS-GE over 3 years were extracted in a retrospective registry. Demographic characteristics, procedure-related information and follow-up data was collected. Primary outcome was the rate of adverse events associated with EUS-GE and the comparison of the rate of adverse events in benign versus malignant diseases. Secondary outcomes included technical and clinical success as well as hospitalization admission.
A total of 103 patients were included: 72 malignant and 31 benign. The characteristics of the patients undergoing EUS-GE is shown in Table 1. The mean age of the cohort was 68 years and 58 years for malignant and benign etiology. Gender distribution was 57% and 39% being females in malignant and benign etiology group, respectively. Clinical success, technical success, average procedure time, and hospital length of stay were similar in both groups. Patients with benign underlying etiology had significantly higher number of surgically altered midgut anatomy ( P =0.0379).
EUS-GE is equally efficient regardless of the underlying etiology (malignant vs. benign), and the adverse events both groups were comparable.
内镜超声引导下胃造口术（EUS-GE）是一种治疗胃出口梗阻的微创疗法，没有手术旁路的风险，也没有肠内自扩张金属支架置入的长期疗效有限的问题。然而，由于其新颖性，缺乏基于潜在疾病的 EUS-GE 患者长期结果的显著数据。在这项研究中，我们比较了 EUS-GE 治疗良性和恶性疾病的结果。
从 12 家国际三级护理中心回顾性提取了 3 年内接受 EUS-GE 的连续患者的注册表。收集了人口统计学特征、与手术相关的信息和随访数据。主要结果是与 EUS-GE 相关的不良事件的发生率以及良性与恶性疾病的不良事件发生率的比较。次要结果包括技术和临床成功率以及住院入院率。
共纳入 103 例患者：72 例恶性和 31 例良性。接受 EUS-GE 的患者特征见表 1。队列的平均年龄为 68 岁，恶性和良性病因的年龄分别为 58 岁。性别分布分别为恶性和良性病因组的 57%和 39%为女性。两组的临床成功率、技术成功率、平均手术时间和住院时间相似。具有良性潜在病因的患者具有明显更高的手术改变的中肠解剖数量（P=0.0379）。
EUS-GE 的效率与潜在病因（恶性与良性）无关，两组的不良事件相当。
