Long-Term Outcomes of Endoscopic Ultrasound-Guided Coloenterostomy With a Lumen-Apposing Metal Stent for Malignant Small Bowel Obstruction.

Background And Aims: Endoscopic ultrasound-guided coloenterostomy (EUS-CE) using lumen-apposing metal stents (LAMS) has emerged as a potential alternative for the palliative treatment of malignant small bowel obstruction (MSBO). However, the long-term outcomes of EUS-CE remain unclear. This study aimed to assess the efficacy and safety of EUS-CE, focusing on long-term outcomes.

Methods: This retrospective cohort study consecutively included patients who underwent EUS-CE for the palliative treatment of MSBO between July 2022 and December 2023 at a tertiary care hospital in China. The longest follow-up period was 362 days. The primary outcomes were overall survival (OS) and symptom recurrence-free survival (SRFS) period. Secondary outcomes included technique success, clinical success, and adverse events (AEs).

Results: A total of 15 patients underwent EUS-CE for MSBO. Technical success was 100%, and clinical success was 93.3%. AEs occurred in 4 (26.7%) patients: one leak, one bleed, and two cases of diarrhea. The median OS period was 65 days, with a 60.0% rate of 60 days survival. The median SRFS period was 165 days, with a 41.7% rate of symptom recurrence at 60 days. All patients survived 30 days, and no symptom recurrence was observed within 30 days. A prolonged OS period was observed in patients without peritoneal carcinomatosis and those who received additional chemoradiotherapy.

Conclusions: EUS-CE is an effective alternative for the palliative treatment of MSBO, demonstrating satisfactory patency and survival benefits based on a long-term cohort.