DOES LUMEN APPOSING METAL STENT (LAMS) DILATION IMPACT EFFICACY AND OUTCOMES OF ENDOSCOPIC ULTRASOUND GUIDED
Recommended Citation
McDonald N, Gouda Z, Boortalary T, Cohen E, Thakkar S, Singh S, Krafft M, Ferrante N, Amin S, Kahaleh M, Tyberg A, Shahid H, Sarkar A, Jamali T, Zuchelli T, Piraka C, Rizzatti G, Larghi A, Kumta N, Ladd AM, Alsamman A, Kedia P, Chiang A, Kumar A, Schlachterman A, Kamal F, Kowalski T. DOES LUMEN APPOSING METAL STENT (LAMS) DILATION IMPACT EFFICACY AND OUTCOMES OF ENDOSCOPIC ULTRASOUND GUIDED. Gastrointest Endosc 2024; 99(6):AB898.
Document Type
Conference Proceeding
Publication Date
6-1-2024
Publication Title
Gastrointest Endosc
Abstract
Introduction: Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) using a lumen apposing metal stent (LAMS) has become an important option for patients with malignant gastric outlet obstruction (GOO). After LAMS placement, the benefit of LAMS dilation remains unclear. We aimed to assess the time to oral intake and adverse event rate in patients who underwent EUS-GE. Methods: This is a multicenter retrospective study of all patients who underwent an EUS-GE using LAMS for GOO at 9 academic medical centers from 9/26/2018 through 10/26/2023. Data was collected regarding patient demographics, procedural characteristics, clinical and technical success, LAMS dilation status, time to oral intake (liquids and solids), length of stay (LOS), readmission rate and duration of follow-up. Technical success was defined as successful deployment of the LAMS to the intended location. Clinical success was defined as the ability to tolerate oral intake within 24 hours of the procedure. Results: A total of 201 patients underwent EUS-GE with LAMS placement. 46.8% were female and the mean age was 64.5 years. The results are summarized in table 1. The LAMS was dilated in 112/201 (55.7%) of cases. Technical success was achieved in 197/201 (98.0%) of cases. Clinical success was achieved in 103/112 (92.0%) of dilated LAMS and 86/89 (96.6%) of non-dilated LAMS. A total of 174 patients (86.6%) were able to be discharged on oral nutrition alone without a secondary source of nutrition (87.5% of dilated LAMS and 85.4% of non-dilated LAMS, p=0.664). Average LOS was 7.5 days in dilated LAMS and 8.4 days in non-dilated LAMS (p=0.272). The average time from procedure to tolerating per oral (PO) liquids was 0.86 days in the dilated group and 1.03 days in the non-dilated group. Average time to tolerating a stent diet was 2.70 days for dilated LAMS and 3.05 days for non-dilated LAMS. Readmission for poor oral intake or GOO was 17/89 (19.1%) for the non-dilation group and 15/112 (13.4%) for the dilation group (p=0.272). The average duration of follow-up was 149 days for the LAMS dilation group and 177 days for the non-dilated group. Conclusion: In our cohort, early tolerance of solid food intake (within 2 days of LAMS placement) was significantly associated with LAMS dilation p=0.015. There was no significant difference in other outcomes including, rates of early PO liquid intake (within 1 day), ability to maintain PO intake at discharge without additional nutrition, or rate of readmission for poor oral intake or GOO.
Volume
99
Issue
6
First Page
AB898
