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

ABSTRACT 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.