Comparative Study of NOTES Versus Endoscopic Ultrasound Gastrojejunostomy in Pigs: A Prospective Study

Ungureanu, Bogdan Silviu; Pătrașcu, Ștefan; Drăgoescu, Alice Nicoleta; Nicolau, Carmen; Copăescu, C; Şurlin, Valeriu; Săftoiu, Adrian

doi:10.1177/1553350617748278

Cited by 7 publications

(3 citation statements)

References 13 publications

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“…Since EUS-GE was reported in porcine models 18 19 , the technique has evolved rapidly mainly for patients with gastric outlet obstruction 20 21 22 23 24 25 26 . Our group published the first US clinical experience with EUS-GE, followed by comparative studies using the technique as an alternative to enteral stenting and surgical gastroenterostomy.…”

Section: Discussionmentioning

confidence: 99%

Durability and long-term outcomes of direct EUS-guided gastroenterostomy using lumen-apposing metal stents for gastric outlet obstruction

et al. 2019

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Background and study aims EUS-guided gastroenterostomy (GE) is a novel, minimally invasive endoscopic procedure for the treatment of gastric outlet obstruction (GOO). The direct-EUS-GE (D-GE) approach has recently gained traction. We aimed to report on a large cohort of patients who underwent DGE with focus on long-term outcomes. Patients and methods This two-center, retrospective study involved consecutive patients who underwent D-GE between October 2014 and May 2018. The primary outcomes were technical and clinical success. Secondary outcomes were adverse events (AEs), rate of reintervention, procedure time, time to resume oral diet, and post-procedure length of stay (LOS). Results A total of 57 patients (50.9 % female; median age 65 years) underwent D-GE for GOO. The etiology was malignant in 84.2 % and benign in 15.8 %. Technical success and clinical success were achieved in 93 % and 89.5 % of patients, respectively, with a median follow-up of 196 days in malignant GOO and 319.5 days in benign GOO. There were 2 (3.5 %) AEs, one severe and one moderate. Median procedure time was 39 minutes (IQR, 26 – 51.5 minutes). Median time to resume oral diet after D-GE was 1 day (IQR 1 – 2 days). Median post D-GE LOS was 3 days (IQR 2 – 7 days). Rate of reintervention was 15.1 %. Conclusions D-GE is safe and effective in management of both malignant and benign causes of GOO. Clinical success with D-GE is durable with a low rate of reintervention based on a long-term cohort.

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Section: Discussionmentioning

confidence: 99%

Durability and long-term outcomes of direct EUS-guided gastroenterostomy using lumen-apposing metal stents for gastric outlet obstruction

et al. 2019

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“…Traditionally, EUS is acknowledged by available guidelines as the main method to assess the T stage in gastric tumors and should be considered after pathologic diagnosis [ 35 ]. Further on, this technique may be also used when gastric outlet obstruction is present, secondary to antral GC, by performing a EUS gastrojejunal anastomosis using lumen-apposing metal stents [ 36 , 37 ]. This proof-of-concept study may impact routine EUS-imaging examination of GC, as it may be easily used in the local extension examination of a gastric tumor by using a contrast agent.…”

Section: Discussionmentioning

confidence: 99%

Gastric Cancer Angiogenesis Assessment by Dynamic Contrast Harmonic Imaging Endoscopic Ultrasound (CHI-EUS) and Immunohistochemical Analysis—A Feasibility Study

Sacerdoțianu

Ungureanu

Iordache

et al. 2022

JPM

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Tumor vascular perfusion pattern in gastric cancer (GC) may be an important prognostic factor with therapeutic implications. Non-invasive methods such as dynamic contrast harmonic imaging endoscopic ultrasound (CHI-EUS) may provide details about tumor perfusion and could also lay out another perspective for angiogenesis assessment. Methods: We included 34 patients with GC, adenocarcinoma, with CHI-EUS examinations that were performed before any treatment decision. We analyzed eighty video sequences with a dedicated software for quantitative analysis of the vascular patterns of specific regions of interest (ROI). As a result, time-intensity curve (TIC) along with other derived parameters were automatically generated: peak enhancement (PE), rise time (RT), time to peak (TTP), wash-in perfusion index (WiPI), ROI area, and others. We performed CD105 and CD31 immunostaining to calculate the vascular diameter (vd) and the microvascular density (MVD), and the results were compared with CHI-EUS parameters. Results: High statistical correlations (p < 0.05) were observed between TIC analysis parameters MVD and vd CD31. Strong correlations were also found between tumor grade and 7 CHI-EUS parameters, p < 0.005. Conclusions: GC angiogenesis assessment by CHI-EUS is feasible and may be considered for future studies based on TIC analysis.

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“…While on a continuous evolution process, EUS has been introduced as a standard diagnosis technique which provides information has paved the way for various new therapeutic options that may substitute several surgical procedures or provide new options for cancer therapies [58]. EUS-drainage of fluid collections represented the grounds for novel techniques which focus on joining two cavities [59]. Along with the additional growth of the industry of endoscopy supplies, EUS has enabled novel therapeutic alternatives.…”

Section: Endoscopic Ultrasoundmentioning

confidence: 99%

Introductory Chapter: Endoscopy-Novel Techniques and Recent Advancements

Streba¹,

Ungureanu²,

IonuțGheonea³

et al. 2019

Endoscopy - Novel Techniques and Recent Advancements

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Comparative Study of NOTES Versus Endoscopic Ultrasound Gastrojejunostomy in Pigs: A Prospective Study

Abstract: No major complications were encountered during both procedures. EUS-GJJ balloon-guided approach might be a more attractive technique by using sonographic guidance, because of less endoscopic instrument changing as well as in achieving the desired anastomotic distance.

Cited by 7 publications

References 13 publications

Durability and long-term outcomes of direct EUS-guided gastroenterostomy using lumen-apposing metal stents for gastric outlet obstruction

Durability and long-term outcomes of direct EUS-guided gastroenterostomy using lumen-apposing metal stents for gastric outlet obstruction

Gastric Cancer Angiogenesis Assessment by Dynamic Contrast Harmonic Imaging Endoscopic Ultrasound (CHI-EUS) and Immunohistochemical Analysis—A Feasibility Study

Introductory Chapter: Endoscopy-Novel Techniques and Recent Advancements

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