GASTROENTEROANASTOMOSIS UNDER ENDOSCOPIC ULTRASOUND GUIDANCE USING METAL LUMEN APPOSING STENT (HOT-AXIOS​): SINGLE-CENTER EXPERIENCE

Aims Gastrointestinal tract obstruction has classically only been able to be solved by surgical techniques. Recent advances in endoscopic ultrasound and the appearance of metallic luminal apposition stents (LAS) have demonstrate an alternative for the treatment of obstructions at the level of the antrum and duodenum being their indication mainly palliative. The present study tries to be one more confirmation of the safety and effectiveness of the technique.

Methods Retrospective, descriptive, observational study of patients who underwent gastroenteroanastomosis through placement of LAS (Hot-AXIOS​) by endoscopic ultrasound in a second-level hospital. Sedation with propofol is controlled by endoscopist and the technique consist on introducing a guide through the stenosis with a 20mm Cook​ Fogarty balloon that allows slow proximal injection of indigo carmine solution to favor its localization. Using this technique, a dilation of the target loop is generated between stenosis and Fogarty-balloon without needing a double balloon. Subsequently a LAS is placed according to the usual technique.

Results Endoscopic ultrasound-guided gastroenteroanastomosis with LAS was performed to 5 patients, being 80% men with mean age of 72.2±14.97 years. Indication was stenosis secondary to pancreatic cancer in 60% of the cases, 20% to gastric neoplasia and ampuloma, respectively. In 100% of the cases, placement was performed from the gastric body with a 15x10mm Hot-Axios​ LAS. The technical success was 100%.

Conclusions Endoscopic gastroenteroanastomosis is a novel technique that represents a breakthrough of great clinical interest in patients with gastrointestinal obstruction, having created easy-to-apply devices and proving to be a safe and effective technique.

Publication History

Article published online:
14 April 2022