Haixin Gao1, Siyu Sun2, Guoxin Wang1, Jintao Guo1, Sheng Wang1, Xiang Liu1, Nan Ge1, Jitong Jiang1, Shiyun Sheng1. 1. Department of GastroenterologyEndoscopic Center, Shengjing Hospital of China Medical University, Sanhao street 36, Shenyang, 110004, Liaoning Province, China. 2. Department of GastroenterologyEndoscopic Center, Shengjing Hospital of China Medical University, Sanhao street 36, Shenyang, 110004, Liaoning Province, China. sun-siyu@163.com.
Abstract
BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.
BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.
Authors: Andrea Ruzzenente; Laura Alaimo; Simone Conci; Mario De Bellis; Andrea Marchese; Andrea Ciangherotti; Tommaso Campagnaro; Alfredo Guglielmi Journal: Updates Surg Date: 2022-08-25
Authors: Jacques A Greenberg; Dessislava I Stefanova; Fernando Valle Reyes; Rodrigo C L Edelmuth; Lamia Harik; Jessica W Thiesmeyer; Caitlin E Egan; Federico Palacardo; Mengyuan Liu; Paul Christos; Felice H Schnoll-Sussman; Philip O Katz; Brendan M Finnerty; Thomas J Fahey; Rasa Zarnegar Journal: Surg Endosc Date: 2022-01-03 Impact factor: 3.453