title: Ex vivo comparison of the lumen-apposing properties of EUS-specific stents (with video).
abstract: OBJECTIVE
  Several EUS-specific stents have become available. It has been claimed that some of these stents have lumen-apposing properties, but objective data measuring such properties are not available. The aim of this study is to measure the lumen-apposing force (LAF) of these stents.
  
  
  METHODS
  The LAF of 3 EUS-specific metallic stents (stents A, N, and S) were compared in an ex vivo setting. Four types of anastomoses were performed with the stents including cholecysto-duodenal, cholecysto-gastric, gastro-gastric, and gastro-jejunal and compared with a hand-sewn (HS) equivalent of the anastomosis. The outcome parameter was the LAF created by each type of stent.
  
  
  RESULTS
  Sixty-four anastomoses were created. The overall mean (standard deviation) LAFs were significantly higher for stents A and S (P < .001). This difference persisted regardless of the type of anastomosis: gastro-gastric (P = .002), gastro-jejunal (P = .005), cholecysto-gastric (P = .002), and cholecysto-jejunal (P = .003). The differences in LAF created by each type of stent across different types of anastomoses were also compared. A trend to significance was observed in the anastomoses created by stent N (P = .064) and stent A (P =.052); a significant difference in LAF was observed among different anastomoses created by stent S (P = .015). The LAF created by HS anastomosis was significantly higher than that for all stents across all anastomoses.
  
  
  CONCLUSIONS
  Stents A and S had a higher LAF. The use of these stents should be considered when performing EUS-guided transmural luminal anastomoses in non-adherent organs. Further studies are required to confirm the clinical efficacies of these EUS-specific stents.
authors.affiliation: Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong.
authors.forename: Anthony Yuen
authors.initials: AY
authors.lastname: Teoh
authors.affiliation: Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong.
authors.forename: Enders Kwok
authors.initials: EK
authors.lastname: Ng
authors.affiliation: Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong.
authors.forename: Shannon Melissa
authors.initials: SM
authors.lastname: Chan
authors.affiliation: Retraction Limited Company, Hong Kong.
authors.forename: Mona
authors.initials: M
authors.lastname: Lai
authors.affiliation: Retraction Limited Company, Hong Kong.
authors.forename: Stuart
authors.initials: S
authors.lastname: Moran
authors.affiliation: Interventional Endoscopy Services, California Pacific Medical Center, San Francisco, California, USA.
authors.forename: Kenneth Frank
authors.initials: KF
authors.lastname: Binmoeller
authors.affiliation: Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon, Seoul, Korea.
authors.forename: Jong Ho
authors.initials: JH
authors.lastname: Moon
authors.affiliation: Department of Medicine, National University of Singapore, Singapore.
authors.forename: Khek Yu
authors.initials: KY
authors.lastname: Ho
mesh_terms: D000714:Anastomosis, Surgical / Q000295:instrumentation / Q000379:methods; D000818:Animals; D002767:Cholecystostomy / Q000295:instrumentation*; D004385:Duodenostomy / Q000295:instrumentation*; D004386:Duodenum / Q000601:surgery; D019160:Endosonography; D005704:Gallbladder / Q000601:surgery; D015390:Gastric Bypass / Q000295:instrumentation*; D005774:Gastrostomy / Q000295:instrumentation*; D007583:Jejunum / Q000601:surgery; D008953:Models, Anatomic; D015607:Stents; D013270:Stomach / Q000601:surgery; D013552:Swine