Preferred techniques for endoscopic ultrasound-guided gastroenterostomy: a survey of expert endosonographers.

Autor:	Magahis PT; MD Program, Weill Cornell Medical College, New York, United States., Salgado S; Division of Gastroenterology and Hepatology, NewYork-Presbyterian Weill Cornell Medical Center, New York, United States., Westerveld D; Division of Gastroenterology and Hepatology, NewYork-Presbyterian Weill Cornell Medical Center, New York, United States., Dawod E; Division of Gastroenterology and Hepatology, NewYork-Presbyterian Weill Cornell Medical Center, New York, United States., Carr-Locke DL; Division of Gastroenterology and Hepatology, NewYork-Presbyterian Weill Cornell Medical Center, New York, United States., Sampath K; Division of Gastroenterology and Hepatology, NewYork-Presbyterian Weill Cornell Medical Center, New York, United States., Sharaiha RZ; Division of Gastroenterology and Hepatology, Weill Cornell Medical College, New York, United States., Mahadev S; Division of Gastroenterology and Hepatology, NewYork-Presbyterian Weill Cornell Medical Center, New York, United States.
Jazyk:	angličtina
Zdroj:	Endoscopy international open [Endosc Int Open] 2023 Nov 09; Vol. 11 (11), pp. E1035-E1045. Date of Electronic Publication: 2023 Nov 09 (Print Publication: 2023).
DOI:	10.1055/a-2185-6426
Abstrakt:	Background and study aims Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) is an emerging procedure that lacks technical standardization with limited adoption beyond expert centers. We surveyed high-volume endosonographers about the technical aspects of EUS-GE to describe how the procedure is currently performed at expert centers and identify targets for standardization. Methods Invitations to complete an electronic survey were distributed to 21 expert EUS practitioners at 19 U.S. centers. Respondents were surveyed about technical aspects of EUS-GE, indications, efficacy, safety, and attitudes toward the procedure. Results All 21 (100%) invited expert endoscopists completed the survey. Nine (42.9%) reported performing >10 EUS-GEs in the last 12 months. About half (47.6%, 10/21) puncture the target loop prior to lumen-apposing metal stent (LAMS) introduction, most often to confirm the loop is jejunum. No respondents reported guidewire placement prior to LAMS introduction. Most (71.4%, 15/21) do not use a guidewire at any time, while 28.6% (6/21) reported wire placement after distal flange deployment to secure the tract during apposition. Eight (38.1%, 8/21) reported at least one major adverse event, most commonly intraperitoneal LAMS deployment (87.5%, 7/8). Factors most often reported as advantageous for EUS-GE over enteral stenting included lack of papilla interference (33.3%, 7/21) and decreased occlusion risk (23.8%, 5/21). Conclusions Significant variation in performance technique for EUS-GE exists among expert US endoscopists, which may hinder widespread adoption and contribute to inconsistencies in reported patient outcomes. The granularity provided by these survey results may identify areas to focus standardization efforts and guide future studies on developing an ideal EUS-GE protocol. Competing Interests: Conflict of Interest Patrick Magahis, Sanjay Salgado, Donevan Westerveld, Enad Dawod, and Kartik Sampath have no conflicts of interest or financial ties to disclose. David Carr-Locke receives royalties from Steris Corporation and consultant fees from Boston Scientific. Reem Sharaiha receives consultant fees from Boston Scientific, Cook Medical, Olympus, and Surgical Intuitive. SriHari Mahadev receives consultant fees from Boston Scientific and Conmed. (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)
Databáze:	MEDLINE
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