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Critical Appraisal of the Impact of Oesophageal Stents in the Management of Oesophageal Anastomotic Leaks and Benign Oesophageal Perforations: An Updated Systematic Review
- Source :
- World Journal of Surgery. 44:1173-1189
- Publication Year :
- 2019
- Publisher :
- Springer Science and Business Media LLC, 2019.
-
Abstract
- Endoscopic placement of oesophageal stents may be used in benign oesophageal perforation and oesophageal anastomotic leakage to control sepsis and reduce mortality and morbidity by avoiding thoracotomy. This updated systematic review aimed to assess the safety and effectiveness of oesophageal stents in these two scenarios. A systematic literature search of all published studies reporting use of metallic and plastic stents in the management of post-operative anastomotic leaks, spontaneous and iatrogenic oesophageal perforations were identified. Primary outcomes were technical (deploying ≥ 1 stent to occlude site of leakage with no evidence of leakage of contrast within 24–48 h) and clinical success (complete healing of perforation or leakage by placement of single or multiple stents irrespective of whether the stent was left in situ or was removed). Secondary outcomes were stent migration, perforation and erosion, and mortality rates. Subgroup analysis was performed for plastic versus metallic stents and anastomotic leaks versus perforations separately. A total of 66 studies (n = 1752 patients) were included. Technical and clinical success rates were 96% and 87%, respectively. Plastic stents had significantly higher migration rates (24% vs 16%, p = 0.001) and repositioning (11% vs 3%, p
- Subjects :
- medicine.medical_specialty
medicine.medical_treatment
Perforation (oil well)
Anastomotic Leak
03 medical and health sciences
Esophagus
0302 clinical medicine
medicine
Humans
Thoracotomy
Esophageal Perforation
business.industry
Mortality rate
Stent
Vascular surgery
equipment and supplies
Cardiac surgery
Surgery
Metals
Cardiothoracic surgery
030220 oncology & carcinogenesis
Stents
030211 gastroenterology & hepatology
business
Plastics
Abdominal surgery
Subjects
Details
- ISSN :
- 14322323 and 03642313
- Volume :
- 44
- Database :
- OpenAIRE
- Journal :
- World Journal of Surgery
- Accession number :
- edsair.doi.dedup.....529482947961696d9480520eef20c316