Anti-reflux versus conventional self-expanding metal stents in the palliation of esophageal cancer: A systematic review and meta-analysis

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art_SASSO_Antireflux_versus_conventional_selfexpanding_metal_stents_in_the_2022.PDF (1.16 MB)
Citações na Scopus
Tipo de produção
article
Data de publicação
2022
DOI
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
GEORG THIEME VERLAG KG
Autores
SANCHEZ-LUNA, Sergio A.
Citação
ENDOSCOPY INTERNATIONAL OPEN, v.10, n.10, p.E1406-E1416, 2022
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background and study aims Self-expanding metal stents (SEMS) are an effective palliative endoscopic therapy to reduce dysphagia in esophageal cancer. Gastroesophageal reflux disease (GERD) is a relatively common complaint after non-valved conventional SEMS placement. Therefore, valved self-expanding metal stents (SEMS-V) were designed to reduce the rate of GERD symptoms. We aimed to perform a systematic review and meta-analysis comparing the two stents. Material and methods This was a systematic review and meta-analysis including only randomized clinical trials (RCT) comparing the outcomes between SEMS-V and non-valved self-expanding metal stents (SEMS-NV) following the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. The risk of bias was assessed using the Cochrane Risk of Bias 2 tool. Data were analyzed with Review Manager Software. Quality of evidence was evaluated using Grading of Recommendations Assessment, Development, and Evaluation guidelines. Results Ten randomized clinical trials including a total of 467 patients, 234 in the SEMS-V group and 233 in the SEMS-NV group, were included. There were no statistically significant differences regarding GERD qualitative analysis (RD -0.17; 95% CI -0.67, 0.33; P= 0.5) and quantitative analysis (SMD -0.22; 95% CI -0.53, 0.08; P=0.15) technical success (RD -0.03; 95% CI -0.07, 0.01; P= 0.16), dysphagia improvement (RD -0.07; 95% CI -0.19, 0.06; P=0.30), and adverse events (RD 0.07; 95% CI -0.07, 0.20; P= 0.32). Conclusions Both SEMS-V and SEMS-NV are safe and effective in the palliation of esophageal cancer with similar rates of GERD, dysphagia relief, technical success, adverse events, stent migration, stent obstruction, bleeding, and improvement of the quality of life.
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URI
https://observatorio.fm.usp.br/handle/OPI/50788
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Coleções
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - HC/ICESP
Artigos e Materiais de Revistas Científicas - LIM/26
Artigos e Materiais de Revistas Científicas - LIM/35
Artigos e Materiais de Revistas Científicas - LIM/47