Transrectal endoscopic ultrasound (EUS) – guided drainage of intrapelvic fluid collections using a Lumen Apposing Metal Stent (LAMS)- a two center case series study

Aims To determine safety and efficacy of Endoscopic ultrasound (EUS)- guided transrectal drainage of intrapelvic fluid collections, mainly abscess collections using a lumen apposing metal stent (LAMS).

Methods A total of 9 patients were submitted to the procedure after signing consent form and being informed that this is an innovative approach. All patients had symptoms such as: lower abdominal pain, fever, elevated C- reactive protein or leukocytosis and a fluid collection in the vicinity of rectum confirmed in an imaging study. In each center only one expert with ~100 therapeutic EUS per year was perfoming this procedure. We utilised single- operator, one-step cystotome+LAMS device in various diameters. The goal was to achieve remission without percutaneous or surgical intervention [1] [2] [3] [4].

Results In 9 out of 9 patients we achieved technical and clinical success. Technical success was defined as creating a fistula between rectum and fluid collection and deployment of LAMS in the fistula. Clinical success was defined as subsiding of the symptoms, lowering of inflammation markers and regression of the fluid collection in imaging study. There were no adverse events, and the patients were discharged soon after the procedure.

Conclusions The transrectal EUS – guided drainage using a LAMS is a safe and efficient method of treatment for various fluid collections in the vicinity of digestive tract wall. It is most commonly used in peripancreatic fluid collections such as pseudocysts and walled-off necroses, however in an expert setting in high volume centers it can also be used in other indications such as drainage of perirectal abscesses or other fluid collections. It is a minimally invasive procedure comparing to surgery, and it allows to achieve fast clinical remission.

Publikationsverlauf

Artikel online veröffentlicht:
27. März 2025

• References

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