Please use this identifier to cite or link to this item: https://observatorio.fm.usp.br/handle/OPI/42479
Title: EUS-guided gastroenterostomy versus duodenal stent placement and surgical gastrojejunostomy for the palliation of malignant gastric outlet obstruction: a systematic review and meta-analysis
Authors: BOGHOSSIAN, Mateus BondFUNARI, Mateus PereiraMOURA, Diogo Turiani Hourneaux DeMCCARTY, Thomas R.SAGAE, Vitor Massaro TakamatsuI, Yen- ChenMENDIETA, Pastor Joaquin OrtizPONTE NETO, Fernando LopesBERNARDO, Wanderley MarquesSANTOS, Marcos Eduardo Lera dosCHAVES, Filipe TomishigeKHASHAB, Mouen A.MOURA, Eduardo Guimaraes Hourneaux de
Citation: LANGENBECKS ARCHIVES OF SURGERY, v.406, n.6, p.1803-1817, 2021
Abstract: Purpose Malignant gastric outlet obstruction (GOO) is associated with significant morbidity and decreased quality of life, thereby necessitating effective and safe palliative treatment. As such, we sought to compare endoscopic ultrasound-guided gastroenterostomy (EUS-GE) versus duodenal stent (DS) placement and surgical gastrojejunostomy (SGJ) for palliation of malignant GOO. Methods Searches of electronic databases were performed to identify studies comparing EUS-GE versus DS and/or SGJ for palliative treatment of GOO. Outcomes included technical and clinical success, severe adverse events (SAEs), rate of stent obstruction (including tumor ingrowth), length of hospital stay (LOS), reintervention, and 30-day all-cause mortality. Differences in dichotomous and continuous outcomes were reported as risk difference and mean difference, respectively. Results Seven studies (n = 513 patients) were included. When compared to DS placement, EUS-GE was associated with a higher clinical success, fewer SAEs, decreased stent obstruction, lower rate of tumor ingrowth, and decreased need for reintervention. Compared to SGJ, EUS-GE was associated with a lower technical success; however, LOS was significantly decreased. All other outcomes including clinical success, SAEs, reintervention rate, and 30-day mortality were not significantly different between an EUS-guided versus surgical approach. Conclusions EUS-GE was associated with significantly improved outcomes compared to DS placement for palliative treatment of malignant GOO. Despite SGJ possessing a higher technical success compared to EUS-GE, LOS was significantly longer with no difference in clinical success or rate of adverse events.
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Artigos e Materiais de Revistas Científicas - HC/ICHC
Instituto Central - HC/ICHC

Artigos e Materiais de Revistas Científicas - LIM/35
LIM/35 - Laboratório de Nutrição e Cirurgia Metabólica do Aparelho Digestivo

Artigos e Materiais de Revistas Científicas - LIM/47
LIM/47 - Laboratório de Hepatologia por Vírus


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