Sequential Lumen-Apposing Metal Stent and Septotomy Technique for Endoscopic Anastomosis Creation and Revision in Patients with Prior Upper Gastrointestinal Surgery.

IF 7.5 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Gastrointestinal endoscopy Pub Date : 2025-10-09 DOI:10.1016/j.gie.2025.10.003

Casey R Lamb, Sara R Zelman, Nicholas S Hannon, Jeffrey M Adler, Thadeus L Trus

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引用次数: 0

Abstract

Background and aims: We present an endoscopic technique for creation or revision of upper gastrointestinal (UGI) anastomoses using endoscopic ultrasound (EUS) guidance, sequential deployment of lumen-apposing metal stents (LAMS), and septotomy after tract maturation. We also present our case series of 4 patients in which we have successfully utilized this technique for both reversal of post-bariatric surgical anatomy and management of anastomotic strictures.

Methods: 3 patients with prior bariatric surgery underwent reversal of their gastric anatomy with endoscopic anastomosis creation, and 1 patient with a duodenal anastomotic stricture underwent anastomotic revision using our sequential LAMS and septotomy technique.

Results: There were no immediate procedure-related adverse events in any of the cases. All procedures achieved technical and at least partial clinical success.

Conclusions: Our technique is safe, effective, and feasible for durable endoscopic anastomosis creation or revision in appropriately selected patients with prior upper GI surgery.

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序贯腔旁置金属支架和中隔切开术在上消化道手术患者的内镜吻合建立和修复中的应用。

背景和目的：我们提出了一种内镜下的技术来创建或修改上消化道（UGI）吻合术，使用内镜超声（EUS）引导，连续部署腔内金属支架（LAMS），并在管道成熟后进行中隔切开术。我们还介绍了我们的4例病例系列，其中我们成功地利用该技术逆转了减肥后手术解剖和处理吻合口狭窄。方法：3例既往减肥手术患者行胃解剖反转内镜吻合术，1例十二指肠吻合口狭窄患者行序贯LAMS和中隔切开术吻合口修复术。结果：所有病例均未发生与手术相关的不良事件。所有的手术都取得了技术上和至少部分临床上的成功。结论：我们的技术是安全、有效和可行的，可以在适当选择的既往上消化道手术的患者中进行持久的内镜吻合术创建或修复。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Gastrointestinal endoscopy 医学-胃肠肝病学

CiteScore

10.30

自引率

7.80%

发文量

1441

审稿时长

38 days

期刊介绍： Gastrointestinal Endoscopy is a journal publishing original, peer-reviewed articles on endoscopic procedures for studying, diagnosing, and treating digestive diseases. It covers outcomes research, prospective studies, and controlled trials of new endoscopic instruments and treatment methods. The online features include full-text articles, video and audio clips, and MEDLINE links. The journal serves as an international forum for the latest developments in the specialty, offering challenging reports from authorities worldwide. It also publishes abstracts of significant articles from other clinical publications, accompanied by expert commentaries.