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Complications of stent placement in patients with esophageal cancer: A systematic review and network meta-analysis

BACKGROUND: Palliative treatments and stents are necessary for relieving dysphagia in patients with esophageal cancer. The aim of this study was to simultaneously compare available treatments in terms of complications. METHODS: Web of Science, Medline, Scopus, Cochrane Library and Embase were search...

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Autores principales: Doosti-Irani, Amin, Mansournia, Mohammad Ali, Rahimi-Foroushani, Abbas, Haddad, Peiman, Holakouie-Naieni, Kourosh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5624586/
https://www.ncbi.nlm.nih.gov/pubmed/28968416
http://dx.doi.org/10.1371/journal.pone.0184784
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author Doosti-Irani, Amin
Mansournia, Mohammad Ali
Rahimi-Foroushani, Abbas
Haddad, Peiman
Holakouie-Naieni, Kourosh
author_facet Doosti-Irani, Amin
Mansournia, Mohammad Ali
Rahimi-Foroushani, Abbas
Haddad, Peiman
Holakouie-Naieni, Kourosh
author_sort Doosti-Irani, Amin
collection PubMed
description BACKGROUND: Palliative treatments and stents are necessary for relieving dysphagia in patients with esophageal cancer. The aim of this study was to simultaneously compare available treatments in terms of complications. METHODS: Web of Science, Medline, Scopus, Cochrane Library and Embase were searched. Statistical heterogeneity was assessed using the Chi(2) test and was quantified by I(2). The results of this study were summarized in terms of Risk Ratio (RR). The random effects model was used to report the results. The rank probability for each treatment was calculated using the p-score. RESULTS: Out of 17855 references, 24 RCTs reported complications including treatment related death (TRD), bleeding, stent migration, aspiration, severe pain and fistula formation. In the ranking of treatments, thermal ablative therapy (p-score = 0.82), covered Evolution® stent (p-score = 0.70), brachytherapy (p-score = 0.72) and antireflux stent (p-score = 0.74) were better treatments in the network of TRD. Thermal ablative therapy (p-score = 0.86), the conventional stent (p-score = 0.62), covered Evolution® stent (p-score = 0.96) and brachytherapy (p-score = 0.82) were better treatments in the network of bleeding complications. Covered Evolution® (p-score = 0.78), uncovered (p-score = 0.88) and irradiation stents (p-score = 0.65) were better treatments in network of stent migration complications. In the network of severe pain, Conventional self-expandable nitinol alloy covered stent (p-score = 0.73), polyflex (p-score = 0.79), latex prosthesis (p-score = 0.96) and brachytherapy (p-score = 0.65) were better treatments. CONCLUSION: According to our results, thermal ablative therapy, covered Evolution® stents, brachytherapy, and antireflux stents are associated with a lower risk of TRD. Moreover, thermal ablative therapy, conventional, covered Evolution® and brachytherapy had lower risks of bleeding. Overall, fewer complications were associated with covered Evolution® stent and brachytherapy.
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spelling pubmed-56245862017-10-17 Complications of stent placement in patients with esophageal cancer: A systematic review and network meta-analysis Doosti-Irani, Amin Mansournia, Mohammad Ali Rahimi-Foroushani, Abbas Haddad, Peiman Holakouie-Naieni, Kourosh PLoS One Research Article BACKGROUND: Palliative treatments and stents are necessary for relieving dysphagia in patients with esophageal cancer. The aim of this study was to simultaneously compare available treatments in terms of complications. METHODS: Web of Science, Medline, Scopus, Cochrane Library and Embase were searched. Statistical heterogeneity was assessed using the Chi(2) test and was quantified by I(2). The results of this study were summarized in terms of Risk Ratio (RR). The random effects model was used to report the results. The rank probability for each treatment was calculated using the p-score. RESULTS: Out of 17855 references, 24 RCTs reported complications including treatment related death (TRD), bleeding, stent migration, aspiration, severe pain and fistula formation. In the ranking of treatments, thermal ablative therapy (p-score = 0.82), covered Evolution® stent (p-score = 0.70), brachytherapy (p-score = 0.72) and antireflux stent (p-score = 0.74) were better treatments in the network of TRD. Thermal ablative therapy (p-score = 0.86), the conventional stent (p-score = 0.62), covered Evolution® stent (p-score = 0.96) and brachytherapy (p-score = 0.82) were better treatments in the network of bleeding complications. Covered Evolution® (p-score = 0.78), uncovered (p-score = 0.88) and irradiation stents (p-score = 0.65) were better treatments in network of stent migration complications. In the network of severe pain, Conventional self-expandable nitinol alloy covered stent (p-score = 0.73), polyflex (p-score = 0.79), latex prosthesis (p-score = 0.96) and brachytherapy (p-score = 0.65) were better treatments. CONCLUSION: According to our results, thermal ablative therapy, covered Evolution® stents, brachytherapy, and antireflux stents are associated with a lower risk of TRD. Moreover, thermal ablative therapy, conventional, covered Evolution® and brachytherapy had lower risks of bleeding. Overall, fewer complications were associated with covered Evolution® stent and brachytherapy. Public Library of Science 2017-10-02 /pmc/articles/PMC5624586/ /pubmed/28968416 http://dx.doi.org/10.1371/journal.pone.0184784 Text en © 2017 Doosti-Irani et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Doosti-Irani, Amin
Mansournia, Mohammad Ali
Rahimi-Foroushani, Abbas
Haddad, Peiman
Holakouie-Naieni, Kourosh
Complications of stent placement in patients with esophageal cancer: A systematic review and network meta-analysis
title Complications of stent placement in patients with esophageal cancer: A systematic review and network meta-analysis
title_full Complications of stent placement in patients with esophageal cancer: A systematic review and network meta-analysis
title_fullStr Complications of stent placement in patients with esophageal cancer: A systematic review and network meta-analysis
title_full_unstemmed Complications of stent placement in patients with esophageal cancer: A systematic review and network meta-analysis
title_short Complications of stent placement in patients with esophageal cancer: A systematic review and network meta-analysis
title_sort complications of stent placement in patients with esophageal cancer: a systematic review and network meta-analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5624586/
https://www.ncbi.nlm.nih.gov/pubmed/28968416
http://dx.doi.org/10.1371/journal.pone.0184784
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