Evidence map›Paper›PMID 39465748›Full record

SynthesisMedicine2024

Endoscopic ultrasound-guided gastroenterostomy versus duodenal stenting for gastric outlet obstruction: A systematic review, meta-analysis, and meta-regression.

Hritvik Jain, Debankur Dey, Ramez M Odat, Ayham Mohammad Hussein, Haleema Qayyum Abbasi, Hritik Madaan, Aman Goyal, Jyoti Jain, Mushood Ahmed, Mohammed Dheyaa Marsool Marsool and 1 more

Abstract readSystematic ReviewMeta-AnalysisComparative Study
In one paragraph

Synthesis in Medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Hritvik JainDepartment of Internal Medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, Jodhpur, India.
Debankur DeyDepartment of Internal Medicine, Medical College Kolkata, Kolkata, West Bengal, India.
Ramez M OdatDepartment of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Ayham Mohammad HusseinFaculty of Medicine, Al-Balqa' Applied University, Salt, Jordan.
Haleema Qayyum AbbasiDepartment of Internal Medicine, Ayub Medical College, Abbottabad, Pakistan.
Hritik MadaanDepartment of Internal Medicine, Adesh Medical College and Hospital, Ambala, India.
Aman GoyalDepartment of Internal Medicine, Seth GS Medical College and KEM Hospital, Mumbai, India.
Jyoti JainDepartment of Internal Medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, Jodhpur, India.
Mushood AhmedDepartment of Internal Medicine, Rawalpindi Medical University, Rawalpindi, Pakistan.
Mohammed Dheyaa Marsool MarsoolDepartment of Internal Medicine, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq.
Rukesh YadavDepartment of Internal Medicine, Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.ORCID 0000-0002-0282-0251

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundGastric outlet obstruction (GOO) refers to mechanical obstruction at the level of the gastric outlet and is associated with significantly impacted quality of life and mortality. Duodenal stenting (DS) offers a minimally invasive approach to managing GOO but is associated with a high risk of stent obstruction. Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) is a novel intervention that uses lumen-apposing metal stents to open the restricted lumen. The current evidence comparing EUS-GE to DS is limited and inconsistent.

methodsWe conducted a systematic literature search on PubMed, Embase, Cochrane, Scopus, and clinicaltrials.gov to retrieve studies comparing EUS-GE to DS for GOO. Odds ratios (OR) and mean differences (MD) with their 95% confidence intervals (CI) were pooled using the DerSimonian-Laird inverse variance random-effects model. Statistical significance was set at P < .05.

resultsTen studies with a total of 1275 GOO patients (585: EUS-GE and 690: DS) were included. EUS-GE was associated with statistically significant higher clinical success [OR: 2.52; 95% CI: 1.64, 3.86; P < .001], lower re-intervention rate [OR: 0.12; 95% CI: 0.06, 0.22; P < .00001], longer procedural time [MD: 20.91; 95% CI: 15.48, 26.35; P < .00001], and lower risk of adverse events [OR: 0.49; 95% CI: 0.29, 0.82; P = .007] than DS. Technical success [OR: 0.62; 95% CI: 0.31, 1.25] and the length of hospital stay [MD: -2.12; 95% CI: -5.23, 0.98] were comparable between the 2 groups.

conclusionEUS-GE is associated with higher clinical success, longer total procedural time, lower re-intervention rate, and lower risk of adverse events than DS. Technical success and the length of hospital stay were comparable between the 2 groups. EUS-GE appears to be a safe and effective procedure for managing GOO. Further large, multicentric randomized controlled trials are warranted to investigate the safety and outcomes of EUS-GE in patients with malignant GOO.

Indexed as

EndosonographyGastric Outlet ObstructionGastroenterostomyStentsDuodenumHumansTreatment OutcomeUltrasonography, Interventional

Identifiers

PMID39465748
PMCPMC11460917

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.