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Natural orifice transluminal endoscopic surgery gastroenterostomy with a biflanged lumen-apposing stent: first clinical experience (with videos)

2014; Elsevier BV; Volume: 81; Issue: 1 Linguagem: Inglês

10.1016/j.gie.2014.09.039

1097-6779

Marc Barthet, Kenneth F. Binmoeller, Geoffroy Vanbiervliet, J.-M. Gonzalez, Todd H. Baron, Stéphane Berdah,

Gastrointestinal disorders and treatments

Background We established feasibility and safety for natural orifice transluminal endoscopic surgery (NOTES) GI anastomosis with a lumen-apposing stent in live pigs. This approach was performed in 3 patients. Objective Creation of a NOTES gastroduodenal anastomosis in patients. Design Case series. Setting Two tertiary-care referral centers at large academic hospitals in France and in the United States. Patients Patients with refractory benign duodenal stenosis and malignant duodenal obstruction. Intervention NOTES GI anastomosis with a lumen-apposing stent. Main Outcome Measurements Disappearence of gastric outlet obstruction. Results All 3 procedures were technically successful and uneventful, except 1 minor adverse event. There were no instances of stent occlusion or migration during follow-up. All patients resumed a normal diet. Limitations Small case series. Conclusion NOTES gastroenteric anastomosis is feasible and safe in humans. A prospective pilot study is warranted. We established feasibility and safety for natural orifice transluminal endoscopic surgery (NOTES) GI anastomosis with a lumen-apposing stent in live pigs. This approach was performed in 3 patients. Creation of a NOTES gastroduodenal anastomosis in patients. Case series. Two tertiary-care referral centers at large academic hospitals in France and in the United States. Patients with refractory benign duodenal stenosis and malignant duodenal obstruction. NOTES GI anastomosis with a lumen-apposing stent. Disappearence of gastric outlet obstruction. All 3 procedures were technically successful and uneventful, except 1 minor adverse event. There were no instances of stent occlusion or migration during follow-up. All patients resumed a normal diet. Small case series. NOTES gastroenteric anastomosis is feasible and safe in humans. A prospective pilot study is warranted.