Table 1 Publications included in the systematic review
Author | Name of publication | Year of publication | Type of study | EUS-GE technique | Misdeployment | Solution for misdeployment |
|---|---|---|---|---|---|---|
Bazaga S et al. Endoscopy 2021 [29] | Intraperitoneal endoscopic salvage using an enteral stent for a misdeployed lumen-apposing metal stent during endoscopic ultrasound-guided gastroenterostomy | 2021 | Case report | Direct = 1 | 1 distal flange misdeployment into the peritoneal cavity | SEMS stent placement through LAMS |
Bejjani M et al. GIE Abstract 2021 [30] | Clinical and Technical Outcomes of patients undergoing EUS-Guided Gastroenterostomy using 20 mm vs 15 mm LAMS | 2021 | Retrospective | n = 267, procedure non-specified | 23 (8.6%); 13 in 15 mm LAMS group; 10 in 20 mm LAMS group. No specification concerning flange available | Not specified |
Chen Y-I. et al. Surg Endosc 2017 [26] | EUS-guided gastroenterostomy is comparable to enteral stenting with fewer re-interventions in malignant gastric outlet obstruction | 2017 | Retrospective | Total 30 EPASS = 22; Balloon assisted = 6; Direct = 2 | 3/30 (10%) misdeployment into the peritoneum | LAMS removal, conservative treatment, one patient requiring surgical therapy for stent removal from the peritoneal cavity |
Chen Y.-I. et al., Gastroenterology 2017 [24] | Displaced Endoscopic Ultrasound-Guided Gastroenterostomy Stent Rescued With Natural Orifice Transluminal Endoscopic Surgery | 2017 | Case report | Direct = 1 | 1 dislodgement of distal flange into the peritoneum | NOTES exploration of the peritoneal cavity, new LAMS deployment using a gastroscope, through the jejunal puncture Defect |
Chen Y.-I. et al., GIE 2018 [14] | EUS-guided gastroenterostomy: a multicenter study comparing the direct and balloon-assisted techniques | 2018 | Retrospective | Total 77 Direct = 52; Balloon assisted = 22 | 5 (7%): stent misdeployment into the peritoneum | Immediate Stent replacement (= 4) technique not specified, defect closure ( n = 1), technique not specified |
Colombo M et al., Am J Gastroenterol 2021 [31] | Salvage Procedure for Double Trouble in Lumen-Apposing Metal Stent Misdeployment During Endoscopic Ultrasound-Guided Gastroenterostomy: Ready to Start Again | 2021 | Case report | Direct = 1 | 1 dislodgement of distal flange | LAMS removal, gastric perforation closure using an omental fat patch, jejunal leak closure using clips, repeated EUS-GE using direct technique in a distal jejunal loop |
Costa Martins et al. VideoGIE 2020 [32] | Lessons learned from a salvage procedure for lumen-apposing metal stent misplacement during EUS-guided gastrojejunal bypass | 2020 | Case report | EPASS = 1 | 1, distal flange misdeployment into the peritoneum | NOTES, exploration of the abdominal cavity, Reassembling of the LAMS system; second successful EPASS attempt |
Kerdsirichairat et al. Endosc Int Open 2019 [21] | Durability and long-term outcomes of direct EUS-guided gastroenterostomy using lumen-apposing metal stents for gastric outlet obstruction | 2019 | Retrospective | Direct = 57 | 2/57 (3.5%); with proximal flange misdeployed in the peritoneum | Immediately retrieved endoscopically and the gastric defects closed with an over-the-scope clip. A new LAMS was then deployed successfully in both cases |
Ge PS et al., Surg Endoscopy 2019 [33] | EUS-guided gastroenterostomy versus enteral stent placement for palliation of malignant gastric outlet obstruction | 2019 | Retrospective analysis of a prospectively collected database | Direct = 22 | 2/22 (8.3%) misdeployment resulting in perforation, site not specified | LAMS deployment in the same session, and neither case required surgery |
Ghandour B., I., EUS-GE Study Group, GIE 2021 [19] | Classification, outcomes and management of misdeployed stents during EUS-guided gastroenterostomy | 2021 | Retrospective | Total 467; balloon assisted + direct puncture technique used, no information concerning n | 46 (9.85%); misdeployment types: I: (distal flange into the peritoneum without enterotomy) = 29 (63.1%); II: (distal flange into the peritoneum despite enterotomy) = 14 (30.4%); III: (distal flange deployed correctly, proximal flange in the peritoneum) = 2 (2.2%); IV: (malpositioning of distal flange in the colon) = 2 (2.2%) | Type I: gastrotomy closure using OTSC/TTSC/Endoscopic suturing/no closure/new LAMS deployment through the same gastrotomy/surgical intervention for peritonitis Type II: new LAMS deployment / Bridging fully covered SEMS through misdeployed LAMS;/NOTES placement of a new LAMS/gastrotomy closure only type III: NOTES retrieval type IV: LAMS removal and fistula closure using TTSC/endoscopic suturing |
Gornals J.B. et al. Endoscopy 2021[34] | Helpful technical notes for intraperitoneal natural orifice transluminal endoscopic surgery (NOTES) salvage in a failed EUS-guided gastroenterostomy scenario | 2021 | Technical paper | Â | Â | (1) if guide wire still in place: new LAMS placement, (2) LAMS in LAMS rescue; (3) NOTES rescue; (4) surgery |
Havre RF et al., Scand J Gastroenterol 2021 [35] | EUS-guided gastroenterostomy with a lumen-apposing self-expandable metallic stent relieves gastric outlet obstruction—a Scandinavian case series | 2021 | Retrospective | Direct = 33 | 1 distal flange misdeployment into the peritoneum | Gastric fistula closure with clips |
Itoi et al. Gut 2016 [16] | Prospective evaluation of endoscopic ultrasonography-guided double-balloon-occluded gastrojejunostomy bypass (EPASS) for malignant gastric outlet obstruction | 2016 | Prospective | EPASS = 20 | 2/20 (10%) stent misemployment location unknown | Stent was removed and the patient was treated by conservative therapy |
James et al. GIE 2020 [25] | EUS-guided gastroenterol anastomosis as a bridge to definitive treatment in benign gastric outlet obstruction | 2020 | Retrospective | Total = 22 orojejunal tube-assisted water instillation = 5 (22.7%), balloon-assisted in 8 (36.4%) and fluid instillation with freehand puncture using electrocautery = 9 (40.9%) | 1/22 (4.5%) transcolonic misdeployment into the jejunum → no signs of perforation | Patient awaiting surgery |
Kouanda et al. Surg Endosc 2021 [36] | Endoscopic ultrasound-guided gastroenterostomy versus open surgical gastrojejunostomy: clinical outcomes and cost effectiveness analysis | 2021 | Retrospective | Direct = 40 | 1/40 (2.5%) deployment into the peritoneum, | LAMS removal, defect closure with OTSC, enteral stent placement |
Ligresti D et al., Endoscopy 2019 [37] | The lumen-apposing metal stent (LAMS)-in-LAMS technique as an intraprocedural rescue treatment during endoscopic ultrasound-guided gastroenterostomy | 2019 | Case report | Balloon assisted = 1 | 1 dislodgement of distal flange into the peritoneum, guide wire still in place in the jejunum | LAMS in LAMS new deployment/bridging |
Endoscopic ultrasound-guided gastroenterostomy using an oroenteric catheter-assisted technique: a retrospective analysis | 2021 | prospectively collected database Retrospective data analysis | Oroenteric catheter-assisted technique = 42 | 1 distal flange misdeployment due to failed sheath retraction | Endoscopic suturing of the gastrotomy (Apollo Overstitch) | |
Perez-Miranda et al. J Clinical Gastroenterol 2017 | EUS-guided Gastrojejunostomy Versus Laparoscopic Gastrojejunostomy An international Collaborative Study | 2017 | Retrospective | Direct = 6, Balloon assisted = 9, Ultraslim endoscope—assisted = 7; Nasobiliary tube assisted = 3 | 9/25 (36%) localization unknown | Bridging fully covered self-expanding metal stent or a second LAMS n = 6, 3 had their LAMS removed and the access site closed with an over-the-scope clip ( n = 1) or an enteral stent ( n = 2) |
Sondhi AR, Law R, VideoGIE 2020 [39] | Intraperitoneal salvage of an EUS-guided gastroenterostomy using a nested lumen-apposing metal stent | 2020 | Case report | Direct = 1 | 1 distal flange misdeployment into the peritoneal cavity | LAMS in LAMS deployment using the same access ecoendoscopically. Finally securing both LAMS with endoscopic sutures |
Tyberg et al. Endosc Int Open 2016 [20] | Endoscopic ultrasound-guided gastrojejunostomy with a lumen-apposing metal stent: a multicenter, international experience | 2016 | Prospective | Total = 26 NOTES = 2, Direct = 3, Balloon assisted = 13, Ultraslim endoscope assisted = 5, Nasobiliary tube assisted = 3 | 7/26 (26.9%) partial LAMS misdeployment, either proximal or distal flange | Misplacement of the proximal flange beyond the gastric wall: tract bridging with fully covered SEMS in 2 of the 4 patients with distal flange misplacement, tract salvage with NOTES access (1 planned and 1 unplanned) and placement of a bridging LAMS instead of an FCSEMS In the 2 patients with unsalvaged distal flange misplacement, the LAMS was pulled back into the stomach and access site was closed with an over-the-scope clip ( n = 1) or an enteral SEMS without any attempt at closure ( n = 1) In 2 additional patients, a bridging FCSEMS was placed despite correct placement of a LAMS because of concerns for delayed migration arising from tenting of the LAMS after deployment |
Wannhoff et al. Surg Endosc 2021 [40] | Endoscopic gastrointestinal anastomose with lumen-apposing metal stents: predictors of technical success | 2021 | Retrospective | Total 35; Direct with cautery = 22, Guidewire assisted n = 10 Others = 2 | 4/35 (11.42%) n = 2 dislocation of distal stent flange; n = 1 dislocation of proximal stent flange; n = 1 unsuccessful puncture of the targeted loop | OTSC closure of gastric wall defect before the second attempt. Jejunal wall defect could not be reached, therefore not occluded |