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Review
Endoscopic stenting for malignant gastric outlet obstruction: focusing on comparison of endoscopic stenting and surgical gastrojejunostomy
Sun Gyo Lim, Chan Gyoo Kim
Clin Endosc 2024;57(5):571-580.   Published online February 23, 2024
DOI: https://doi.org/10.5946/ce.2023.160
AbstractAbstract PDFPubReaderePub
Malignant gastric outlet obstruction (GOO) is a condition characterized by blockage or narrowing where the stomach empties its contents into the small intestine due to primary malignant tumors or metastatic diseases. This condition leads to various symptoms such as nausea, vomiting, abdominal pain, and weight loss. To manage malignant GOO, different treatment options have been employed, including surgical gastrojejunostomy (SGJ), gastroduodenal stenting (GDS) using self-expandable metallic stent (SEMS), and endoscopic ultrasound-guided gastrojejunostomy (EUS-GJ). This review focuses on comparing the clinical outcomes of endoscopic stenting (GDS and EUS-GJ) with SGJ for malignant GOO. Studies have shown that GDS with SEMS provides comparable clinical outcomes and safety for the palliation of obstructive symptoms. The choice between covered and uncovered SEMS remains controversial, as different studies have reported varying results. EUS-GJ, performed via endoscopic ultrasound guidance, has shown promising efficacy and safety in managing malignant GOO, but further studies are needed to establish it as the primary treatment option. Comparative analyses suggest that GDS has higher recurrence and reintervention rates compared to EUS-GJ and SGJ, with similar overall procedural complications. However, bleeding rates were lower with GDS than with SGJ. Randomized controlled trials are required to determine the optimal treatment approach for malignant GOO.

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  • Palliative management for malignant biliary obstruction and gastric outlet obstruction from pancreatic cancer
    Pengfei Wu, Kai Chen, Jin He
    Annals of Gastroenterological Surgery.2024;[Epub]     CrossRef
  • 3,942 View
  • 380 Download
  • 1 Web of Science
  • 1 Crossref
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Original Article
Diode Laser—Can It Replace the Electrical Current Used in Endoscopic Submucosal Dissection?
Yunho Jung, Gwang Ho Baik, Weon Jin Ko, Bong Min Ko, Seong Hwan Kim, Jin Seok Jang, Jae-Young Jang, Wan-Sik Lee, Young Kwan Cho, Sun Gyo Lim, Hee Seok Moon, In Kyung Yoo, Joo Young Cho
Clin Endosc 2021;54(4):555-562.   Published online January 13, 2021
DOI: https://doi.org/10.5946/ce.2020.229
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background
/Aims: A new medical fiber-guided diode laser system (FDLS) is expected to offer high-precision cutting with simultaneous hemostasis. Thus, this study aimed to evaluate the feasibility of using the 1,940-nm FDLS to perform endoscopic submucosal dissection (ESD) in the gastrointestinal tract of an animal model.
Methods
In this prospective animal pilot study, gastric and colorectal ESD using the FDLS was performed in ex vivo and in vivo porcine models. The completeness of en bloc resection, the procedure time, intraprocedural bleeding, histological injuries to the muscularis propria (MP) layer, and perforation were assessed.
Results
The en bloc resection and perforation rates in the ex vivo study were 100% (10/10) and 10% (1/10), respectively; those in the in vivo study were 100% (4/4) and 0% for gastric ESD and 100% (4/4) and 25% (1/4) for rectal ESD, respectively. Deep MP layer injuries tended to occur more frequently in the rectal than in the gastric ESD cases, and no intraprocedural bleeding occurred in either group.
Conclusions
The 1,940-nm FDLS was capable of yielding high en bloc resection rates without intraprocedural bleeding during gastric and colorectal ESD in animal models.

Citations

Citations to this article as recorded by  
  • Use of Diode Laser in Hysteroscopy for the Management of Intrauterine Pathology: A Systematic Review
    Andrea Etrusco, Giovanni Buzzaccarini, Antonio Simone Laganà, Vito Chiantera, Salvatore Giovanni Vitale, Stefano Angioni, Maurizio Nicola D’Alterio, Luigi Nappi, Felice Sorrentino, Amerigo Vitagliano, Tommaso Difonzo, Gaetano Riemma, Liliana Mereu, Alessa
    Diagnostics.2024; 14(3): 327.     CrossRef
  • Recent advances in endoscopic management of gastric neoplasms
    Hira Imad Cheema, Benjamin Tharian, Sumant Inamdar, Mauricio Garcia-Saenz-de-Sicilia, Cem Cengiz
    World Journal of Gastrointestinal Endoscopy.2023; 15(5): 319.     CrossRef
  • Safety and efficacy of dual emission endoscopic laser treatment in patients with upper or lower gastrointestinal vascular lesions causing chronic anemia: results from the first multicenter cohort study
    Gian Eugenio Tontini, Lorenzo Dioscoridi, Alessandro Rimondi, Paolo Cantù, Flaminia Cavallaro, Aurora Giannetti, Luca Elli, Luca Pastorelli, Francesco Pugliese, Massimiliano Mutignani, Maurizio Vecchi
    Endoscopy International Open.2022; 10(04): E386.     CrossRef
  • 4,609 View
  • 136 Download
  • 3 Web of Science
  • 3 Crossref
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Case Report
Insertion of Self Expandable Metal Stent for Malignant Stomal Obstruction in a Patient with Advanced Colon Cancer
Jeong Ook Wi, Sung Jae Shin, Jun Hwan Yoo, Jeong Woo Choi, Byung-Hyun Yoo, Sun Gyo Lim, Kee Myung Lee, Jin Hong Kim
Clin Endosc 2012;45(4):448-450.   Published online November 30, 2012
DOI: https://doi.org/10.5946/ce.2012.45.4.448
AbstractAbstract PDFPubReaderePub

Self expandable metal stent can be used both as palliative treatment for malignant colorectal obstruction and as a bridge to surgery in patients with potentially resectable colorectal cancer. Here, we report a case of successful relief of malignant stomal obstruction using a metal stent. A 56-year-old man underwent loop ileostomy and was given palliative chemotherapy for ascending colon cancer with peritoneal carcinomatosis. Eight months after the surgery, he complained of abdominal pain and decreased fecal output. Computed tomography and endoscopy revealed malignant stomal obstruction. Due to his poor clinical condition, we inserted the stent at the stomal orifice, instead of additional surgery, and his obstructive symptoms were successfully relieved. Stent insertion is thought to be a good alternative treatment for malignant stomal obstruction, instead of surgery.

Citations

Citations to this article as recorded by  
  • Endoscopic transstomal stent insertion: a novel approach for a stenosed stoma in a challenging patient
    Feras Aljarad, Ashutosh Gumber, Anne Marie McLeary, Kawan Shalli
    Annals of Coloproctology.2023; 39(4): 357.     CrossRef
  • Use of metallic stents in the management of stenotic bowel stomas
    Mohammad Arabi, Hasan Aljaziri, Mohammed Rashid Akhtar, Tim Fotheringham
    International Journal of Gastrointestinal Intervention.2022; 11(4): 201.     CrossRef
  • Metal Stent Insertion for Malignant Obstruction of a Colostomy
    Antonios Wehbeh, Mahmoud Rahal, Hala Fatima
    Cureus.2020;[Epub]     CrossRef
  • 6,605 View
  • 40 Download
  • 3 Crossref
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