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- Title
Systematic review: the role of self-expanding plastic stents for benign oesophageal strictures.
- Authors
REPICI, A.; HASSAN, C.; SHARMA, P.; CONIO, M.; SIERSEMA, P.
- Abstract
Aliment Pharmacol Ther 31, 1268–1275 Background Treatment of refractory or recurrent benign oesophageal strictures is demanding and surgery may be the only available option. The role of self-expanding plastic stents (SEPS) in the treatment of these strictures is still controversial because of the conflicting results of various studies. Aim To analyse with regard to SEPS: technical and clinical success, factors associated with outcome, and safety . Methods Pooled-data analysis of a systematic review of the literature. Clinical success was defined as no need for further endoscopic or surgical treatment after SEPS removal. Results Data of 10 studies with 130 treated patients were included. SEPS insertion was technically successful in 128 of 130 patients (98%, 95% CI = 96–100%). Clinical success was achieved in 68 patients (52%, 95% CI = 44–61%) and this was found to be lower in those with a cervical localization of the stricture (33% vs . 54%; P < 0.05). Early (<4 weeks) migration of the stent was reported in 19 (24%, 95% CI = 14–32%) cases, while post-insertion endoscopic re-intervention was required in 25 (21%, 95% CI = 14–28%). Major clinical complications occurred in 12 patients (9%, 95% CI = 4–14%), resulting in death of one (0.8%) patient. Conclusions Our pooled-data analysis showed a favourable risk/benefit ratio when SEPS are applied in patients with recurrent or refractory benign oesophageal strictures. This supports the use of SEPS before referring patients to surgery, and they are a valuable alternative to repeat endoscopic dilation.
- Subjects
ESOPHAGEAL stenosis; ENDOSCOPIC surgery; SURGICAL stents; ENDOSCOPIC surgery complications; ESOPHAGEAL perforation
- Publication
Alimentary Pharmacology & Therapeutics, 2010, Vol 31, Issue 12, p1268
- ISSN
0269-2813
- Publication type
Article
- DOI
10.1111/j.1365-2036.2010.04301.x