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

<h4>Background</h4>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.<h4>Methods</h4>Web of Science, Medline, Scopus, Co...

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Main Authors: Amin Doosti-Irani, Mohammad Ali Mansournia, Abbas Rahimi-Foroushani, Peiman Haddad, Kourosh Holakouie-Naieni
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2017-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0184784
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author Amin Doosti-Irani
Mohammad Ali Mansournia
Abbas Rahimi-Foroushani
Peiman Haddad
Kourosh Holakouie-Naieni
author_facet Amin Doosti-Irani
Mohammad Ali Mansournia
Abbas Rahimi-Foroushani
Peiman Haddad
Kourosh Holakouie-Naieni
author_sort Amin Doosti-Irani
collection DOAJ
description <h4>Background</h4>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.<h4>Methods</h4>Web of Science, Medline, Scopus, Cochrane Library and Embase were searched. Statistical heterogeneity was assessed using the Chi2 test and was quantified by I2. 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.<h4>Results</h4>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.<h4>Conclusion</h4>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 doaj-art-a62f006d5fdb4b918a41f74466c47eb62025-08-20T03:56:05ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-011210e018478410.1371/journal.pone.0184784Complications of stent placement in patients with esophageal cancer: A systematic review and network meta-analysis.Amin Doosti-IraniMohammad Ali MansourniaAbbas Rahimi-ForoushaniPeiman HaddadKourosh Holakouie-Naieni<h4>Background</h4>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.<h4>Methods</h4>Web of Science, Medline, Scopus, Cochrane Library and Embase were searched. Statistical heterogeneity was assessed using the Chi2 test and was quantified by I2. 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.<h4>Results</h4>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.<h4>Conclusion</h4>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.https://doi.org/10.1371/journal.pone.0184784
spellingShingle Amin Doosti-Irani
Mohammad Ali Mansournia
Abbas Rahimi-Foroushani
Peiman Haddad
Kourosh Holakouie-Naieni
Complications of stent placement in patients with esophageal cancer: A systematic review and network meta-analysis.
PLoS ONE
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
url https://doi.org/10.1371/journal.pone.0184784
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AT peimanhaddad complicationsofstentplacementinpatientswithesophagealcancerasystematicreviewandnetworkmetaanalysis
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