Dataset Information

EUS-guided decompression of a large mucinous cyst through an electrocautery-enhanced lumen-apposing metal stent.

ABSTRACT:

SUBMITTER: Khosravi F

PROVIDER: S-EPMC5989303 | biostudies-literature | 2016 Nov

REPOSITORIES: biostudies-literature

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EUS-guided decompression of a large mucinous cyst through an electrocautery-enhanced lumen-apposing metal stent.

Khosravi Farhoud F Khosla Manraj M Das Ananya A Sachdev Mankanwal M

VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy 20160913 3

PMID: 29905197

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Project description:Background and aimsPelvic fluid collections (PFCs) are frequent adverse events of abdominal surgery or inflammatory conditions. A percutaneous approach to deep PFCs could be challenging and result in a longer, painful recovery. The transvaginal approach has been considered easy but is limited by the difficulty of leaving a stent in place. The transrectal approach has been described, but issues related to fecal contamination were hypothesized. Data on EUS-guided transrectal drainage (EUS-TRD) with lumen-apposing metal stents (LAMSs) are few and suggest unsatisfactory outcomes. The aim of this study was to evaluate the safety and efficacy of EUS-TRD with LAMSs in patients with PFCs.MethodsA retrospective analysis of a prospectively maintained database on therapeutic EUS was conducted. All EUS-TRD procedures were included.ResultsFive patients (2 male, age 44-89 years) were included. Four patients had postoperative PFCs, and 1 presented with a pelvic abscess complicating acute diverticulitis. Two of 5 had fecal diversion; the remaining 3 had unaltered large-bowel anatomy. One case had a concomitant abdominal collection, treated with percutaneous drainage in the same session. An electrocautery-enhanced LAMS delivery system (15 × 10 mm) was used in all cases. EUS-TRD was performed with the direct-puncture technique and lasted less than 10 minutes in 4 cases; in the remaining case, needle puncture and LAMS placement over a guidewire was required, and the procedure length was 14 minutes. The clinical success rate was 100%. LAMSs were removed after a median of 14 (range, 12-24) days. One patient reported partial proximal LAMS migration after 24 days (mild adverse event). No PFC recurrence was observed.ConclusionEUS-TRD with LAMSs is a safe and effective technique for treatment of PFCs. The use of 15- × 10-mm LAMSs allows rapid PFC resolution. EUS-TRD could be performed not only in patients with fecal diversion but also in cases of unaltered anatomy.

Dataset Information

EUS-guided decompression of a large mucinous cyst through an electrocautery-enhanced lumen-apposing metal stent.

Publications

EUS-guided decompression of a large mucinous cyst through an electrocautery-enhanced lumen-apposing metal stent.

Similar Datasets

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