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- Title
Hemostasis in uncontrolled esophageal variceal bleeding by self−expanding metal stents: a systematic review.
- Authors
Pontone, Stefano; Giusto, Michela; Filippini, Angelo; Cicerone, Clelia; Pironi, Daniele; Merli, Manuela
- Abstract
Aim: The aim of this systematic review was to evaluate the current reported efficacy and the mortality rate of SEMS treatment in uncontrolled bleeding patients. Background: Esophageal variceal bleeding (EVB) represents a life threatening pathology. Despite the adequate pharmacologic and endoscopic treatment, continuous or recurrent bleeding, named as uncontrolled bleeding, occurs in 10-20% of cases. A new removable, covered, and self-expanding metal stent (SEMS) was proposed to control the variceal bleeding. Materials and methods: The study was conducted according to the PRISMA statement. Studies were identified by searching MEDLINE (1989-present) and SCOPUS (1989-present) databases. The last search was run on 01 July 2015. Results: Nine studies (period range=2002-2015) met the inclusion criteria and were included in quantitative analysis. High rate of SEMS efficacy in controling acute bleeding was observed, with a reported percentage ranging from 77.7 to 100%. In 10% to 20% of patients, re-bleeding occurred with SEMS in situ. Stent deployment was successful in 77.8% to 100% of patients while 11 to 36.5% of patients experienced stent migration. Conclusion: SEMS could be effective and safe in control EVB and can be proposed as a reliable option to ballon tamponed for patient stabilization and as a bridging to other therapeutic approach.
- Subjects
HEMORRHAGE treatment; DATABASES; ESOPHAGEAL varices; GASTROENTEROLOGY; HEMOSTASIS; CIRRHOSIS of the liver; MEDLINE; META-analysis; METALS; SURGICAL stents; OPERATIVE surgery; ADULT education workshops; SURGICAL equipment; PATIENT selection; DISEASE complications; DIAGNOSIS
- Publication
Gastroenterology & Hepatology from Bed to Bench, 2016, Vol 9, Issue 1, p6
- ISSN
2008-2258
- Publication type
Article