Background: Current management of malignant obstruction of the upper digestive tract includes
surgical gastrointestinal bypass or endoscopic insertion of self-expandable metal
stents. The safety, efficacy, and long-term patency rates of anastomoses created using
the novel technique of endoscopic gastroenteric anastomosis using magnets (EGAM) are
evaluated in this study.
Patients and Methods: 15 patients (13 men, 2 women; mean age 64.5 years) with malignant obstruction, who
underwent EGAM and had monthly follow-up between December 2001 and May 2003, were
included in this study.Results: The procedure was successful in 13 patients (88.66 %). The mean survival was 5.23
months. There were four minor complications (30.76 %) during the follow-up period.
Conclusion: Our results demonstrate the feasibility, safety. and efficacy of this technique for
creating a gastroenteric anastomosis. The success rate was 86.6 %, there were no immediate
complications, and there was no mortality related to the procedure.
References
- 1
Murphy J B.
Cholecysto-intestinal anastomosis, and approximation without sutures (original research).
Med Rec NY.
1892;
42
665-676
- 2
Forde K A, McLarty A J, Tsai J. et al .
Murphy’s button revisited: clinical experience with the biofragmentable anastomotic
ring.
Ann Surg.
1993;
217
78-81
- 3
Saveliev V S, Avaliani M V, Bashirov A D.
Endoscopic magnetic cholecystodigestive anastomoses: personal technique for palliative
treatment of distal bile duct obstruction.
J Laparoendosc Surg.
1993;
3
99-112
- 4
Cope C.
Creation of compression gastroenterostomy by means of the oral, percutaneous, or surgical
introduction of magnets: feasibility study in swine.
J Vasc Interv Radiol.
1995;
6
539-545
- 5
Cope C, Ginsberg G G.
Long-term patency of experimental magnetic compression gastroenteric anastomoses achieved
with covered stents.
Gastrointest Endosc.
2001;
53
780-784
- 6
Cope C, Clark T WI, Ginsberg G, Habecker P.
Stent placement of gastroenteric anastomosis formed by magnetic compression.
J Vasc Interv Radiol.
1999;
10
1379-1386
- 7
Lillemoe K D, Pitt H A.
Palliation, surgical and otherwise.
Cancer.
1996;
78
605-614
- 8
Nasif T, Prat F. et al .
Endoscopic palliation of malignant gastric outlet obstruction using SEMS.
Endoscopy.
2003;
35
483-489
- 9
Di Fronzo L A, Cymerman J. et al .
Unresectable pancreatic carcinoma: correlating length of survival with choice of palliative
bypass.
Am Surg.
1999;
65
955-958
- 10
Deziel D J, Wilhelmi B. et al .
Surgical palliation for ductal adenocarcinoma of the pancreas.
Am Surg.
1996;
62
582-588
- 11
Van Vangensveld B A, Coene P PLO. et al .
Outcome of palliative biliary and gastric bypass surgery for pancreatic head carcinoma
in 126 patients.
Br J Surg.
1997;
84
1402-1406
- 12
Watanapa P, Williamson R CN.
Surgical palliation for pancreatic cancer: developments during the past two decades.
Br J Surg.
1992;
79
8-20
- 13
Nagy A, Brosseuk D. et al .
Laparoscopic gastroenterostomy for duodenal obstruction.
Am J Surg.
1995;
169
539-542
- 14
Lillemoe K D, Cameron J N. et al .
Is prophylactic gastrojejunostomy indicated for unresectable periampullary cancer?
A prospective randomised trial.
Ann Surg.
1999;
230
322-328
- 15
Carr-Locke D L.
Role of endoscopic stenting in the duodenum.
Ann Oncol.
1999;
10 (Suppl 4)
261-264
- 16
Bethge N, Breitkreutz C, Vakil N.
Metal stents for the palliation of inoperable upper gastrointestinal stenoses.
Am J Gastroenterol.
1998;
93
643-645
- 17
Soetikno R M, Lichtenstein D R, Vandervoort J. et al .
Palliation of malignant gastric outlet obstruction using an endoscopically placed
Wallstent.
Gastrointest Endosc.
1998;
47
267-270
- 18
Yates M R, Morgan D E, Baron T H.
Palliation of malignant gastric and small intestinal strictures with self-expandable
metal stents.
Endoscopy.
1998;
30
266-272
- 19
De Baere T, Harry G, Ducreux M. et al .
Self-expanding metallic stents as palliative treatment of malignant gastroduodenal
stenosis.
AJR Am J Roentgenol.
1997;
169
1079-1083
- 20
Yim H B, Jacobson B C, Saltzman J R. et al .
Clinical outcome of the use of enteral stents for palliation of patients with malignant
upper GI obstruction.
Gastrointest Endosc.
2001;
53
329-332
- 21
Baron T H, Harewood G C.
Enteral self-expandable stents.
Gastrointest Endosc.
2003;
58
421-433
N. A. Chopita, M. D., Ph. D.
Department of Gastroenterology, San Martin Hospital
Calle 2, no. 76 · 1900 La Plata · Argentina
Fax: +54-221-4225111
Email: chopita@netverk.com.ar