Endoscopic Gastroenteric Anastomosis Using Magnets

 

 Buy Article Permissions and Reprints

Background: Current management of malignant obstruction of the upper digestive tract includes surgical gastrointestinal bypass or endoscopic insertion of self-expandable metal stents. The safety, efficacy, and long-term patency rates of anastomoses created using the novel technique of endoscopic gastroenteric anastomosis using magnets (EGAM) are evaluated in this study.
Patients and Methods: 15 patients (13 men, 2 women; mean age 64.5 years) with malignant obstruction, who underwent EGAM and had monthly follow-up between December 2001 and May 2003, were included in this study.Results: The procedure was successful in 13 patients (88.66 %). The mean survival was 5.23 months. There were four minor complications (30.76 %) during the follow-up period.
Conclusion: Our results demonstrate the feasibility, safety. and efficacy of this technique for creating a gastroenteric anastomosis. The success rate was 86.6 %, there were no immediate complications, and there was no mortality related to the procedure.

References

• 1 Murphy J B. Cholecysto-intestinal anastomosis, and approximation without sutures (original research).  Med Rec NY. 1892;  42 665-676
  MissingFormLabel

  PubMedSearch in Google Scholar
• 2 Forde K A, McLarty A J, Tsai J. et al . Murphy’s button revisited: clinical experience with the biofragmentable anastomotic ring.  Ann Surg. 1993;  217 78-81
  MissingFormLabel

  PubMedSearch in Google Scholar
• 3 Saveliev V S, Avaliani M V, Bashirov A D. Endoscopic magnetic cholecystodigestive anastomoses: personal technique for palliative treatment of distal bile duct obstruction.  J Laparoendosc Surg. 1993;  3 99-112
  MissingFormLabel

  PubMedSearch in Google Scholar
• 4 Cope C. Creation of compression gastroenterostomy by means of the oral, percutaneous, or surgical introduction of magnets: feasibility study in swine.  J Vasc Interv Radiol. 1995;  6 539-545
  MissingFormLabel

  CrossrefPubMedSearch in Google Scholar
• 5 Cope C, Ginsberg G G. Long-term patency of experimental magnetic compression gastroenteric anastomoses achieved with covered stents.  Gastrointest Endosc. 2001;  53 780-784
  MissingFormLabel

  CrossrefPubMedSearch in Google Scholar
• 6 Cope C, Clark T WI, Ginsberg G, Habecker P. Stent placement of gastroenteric anastomosis formed by magnetic compression.  J Vasc Interv Radiol. 1999;  10 1379-1386
  MissingFormLabel

  CrossrefPubMedSearch in Google Scholar
• 7 Lillemoe K D, Pitt H A. Palliation, surgical and otherwise.  Cancer. 1996;  78 605-614
  MissingFormLabel

  CrossrefPubMedSearch in Google Scholar
• 8 Nasif T, Prat F. et al . Endoscopic palliation of malignant gastric outlet obstruction using SEMS.  Endoscopy. 2003;  35 483-489
  MissingFormLabel

  Thieme ConnectPubMedSearch in Google Scholar
• 9 Di Fronzo L A, Cymerman J. et al . Unresectable pancreatic carcinoma: correlating length of survival with choice of palliative bypass.  Am Surg. 1999;  65 955-958
  MissingFormLabel

  PubMedSearch in Google Scholar
• 10 Deziel D J, Wilhelmi B. et al . Surgical palliation for ductal adenocarcinoma of the pancreas.  Am Surg. 1996;  62 582-588
  MissingFormLabel

  PubMedSearch in Google Scholar
• 11 Van Vangensveld B A, Coene P PLO. et al . Outcome of palliative biliary and gastric bypass surgery for pancreatic head carcinoma in 126 patients.  Br J Surg. 1997;  84 1402-1406
  MissingFormLabel

  CrossrefPubMedSearch in Google Scholar
• 12 Watanapa P, Williamson R CN. Surgical palliation for pancreatic cancer: developments during the past two decades.  Br J Surg. 1992;  79 8-20
  MissingFormLabel

  CrossrefPubMedSearch in Google Scholar
• 13 Nagy A, Brosseuk D. et al . Laparoscopic gastroenterostomy for duodenal obstruction.  Am J Surg. 1995;  169 539-542
  MissingFormLabel

  CrossrefPubMedSearch in Google Scholar
• 14 Lillemoe K D, Cameron J N. et al . Is prophylactic gastrojejunostomy indicated for unresectable periampullary cancer? A prospective randomised trial.  Ann Surg. 1999;  230 322-328
  MissingFormLabel

  CrossrefPubMedSearch in Google Scholar
• 15 Carr-Locke D L. Role of endoscopic stenting in the duodenum.  Ann Oncol. 1999;  10 (Suppl 4) 261-264
  MissingFormLabel

  PubMedSearch in Google Scholar
• 16 Bethge N, Breitkreutz C, Vakil N. Metal stents for the palliation of inoperable upper gastrointestinal stenoses.  Am J Gastroenterol. 1998;  93 643-645
  MissingFormLabel

  CrossrefPubMedSearch in Google Scholar
• 17 Soetikno R M, Lichtenstein D R, Vandervoort J. et al . Palliation of malignant gastric outlet obstruction using an endoscopically placed Wallstent.  Gastrointest Endosc. 1998;  47 267-270
  MissingFormLabel

  PubMedSearch in Google Scholar
• 18 Yates M R, Morgan D E, Baron T H. Palliation of malignant gastric and small intestinal strictures with self-expandable metal stents.  Endoscopy. 1998;  30 266-272
  MissingFormLabel

  PubMedSearch in Google Scholar
• 19 De Baere T, Harry G, Ducreux M. et al . Self-expanding metallic stents as palliative treatment of malignant gastroduodenal stenosis.  AJR Am J Roentgenol. 1997;  169 1079-1083
  MissingFormLabel

  PubMedSearch in Google Scholar
• 20 Yim H B, Jacobson B C, Saltzman J R. et al . Clinical outcome of the use of enteral stents for palliation of patients with malignant upper GI obstruction.  Gastrointest Endosc. 2001;  53 329-332
  MissingFormLabel

  CrossrefPubMedSearch in Google Scholar
• 21 Baron T H, Harewood G C. Enteral self-expandable stents.  Gastrointest Endosc. 2003;  58 421-433
  MissingFormLabel

  CrossrefPubMedSearch in Google Scholar

N. A. Chopita, M. D., Ph. D.

Department of Gastroenterology, San Martin Hospital

Calle 2, no. 76 · 1900 La Plata · Argentina

Fax: +54-221-4225111

Email: chopita@netverk.com.ar