The addition of flexible endoscopic suturing to stenting for the management of transmural esophageal wall defects: a single tertiary center experience

Obaitan, Itegbemie; DeWitt, John M.; Bick, Benjamin L.; Calderón, Gerardo; Patel, Feenalie; Ghafoor, Adil; Kundumadam, Shanker; Gutta, Aditya; Gromski, Mark A.; Al‐Haddad, Mohammad

doi:10.1007/s00464-021-08628-2

Cited by 3 publications

(7 citation statements)

References 20 publications

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“…The initial research resulted in 4324 individual articles. After applying the exclusion criteria, ten studies [22][23][24][25][26][27][28][29][30][31] (1014 patients) were eligible for analysis. Figure 2 depicts the PRISMA flowchart and Table 1 summarizes the main characteristics of the included studies.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…Figure 2 depicts the PRISMA flowchart and Table 1 summarizes the main characteristics of the included studies. All of the studies were retrospective, [22,23,[25][26][27][28][29]31] except for those assessing TTSC fixation, [24,30] including a prospective comparative study [24] and a randomized controlled trial (RCT). [30] A total of 424 cases underwent SEMS fixation, whereas 625 cases belonged to the control group of simple ES placement.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…In order to assess any impact of these stents on the final outcome, a sensitivity analysis included only studies with clear data of patients who received FC-SEMS. [24][25][26][27][28][29]31] The stent migration rates after fixation were still significantly lower, compare to the non-fixation group [OR: 0.14 (95%CI: 0.05-0.40); I 2 =81%, p=<0.001] (Supplementary Figure 4).…”

Section: Sensitivity Analysismentioning

confidence: 99%

“…All studies, but one [29], were graded as having very good quality, scoring at least 8/9 according to the Newcastle-Ottawa Scale. More specifically, six of them scored 9/9 [22,24,[26][27][28]30] and three scored 8/9 [23,25,31] due to absence of details on follow-up. Only one study [29] did not provide any information about follow-up to explain the time of stent migration assessment, especially in asymptomatic patients (Table 2 s).…”

Section: Quality Assessmentmentioning

confidence: 99%

“…The initial search resulted in 4324 individual articles. After applying the exclusion criteria, 10 studies [22][23][24][25][26][27][28][29][30][31], including 1014 patients, were eligible for analysis. ▶ Fig.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

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Success rates of fixation techniques on prevention of esophageal stent migration: a systematic review and meta-analysis

et al. 2023

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Background and study aims: Esophageal stenting (ES) is an important intervention for the management of malignant and benign dysphagia, with migration representing a common drawback. This systematic review with meta-analysis aimed to assess the benefit of ES fixation over non-fixated stenting. Patients Methods: A systematic research was performed in MEDLINE, Cochrane, Scopus and ClinicalTrials.gov databases until January 2023 for comparative studies evaluating the migration rates of ES after anchoring or not. The primary outcome included the difference of migration rates for fixated and non-fixated ES, with the rate of adverse events being secondary outcome. A subgroup analysis stratified the results based on different fixation techniques; suturing, over the scope clipping (OTSC) and trough the scope clipping (TTSC). Meta-analyses were based on random effects model and the results were reported as odds ratios (OR), with 95% Confidence Intervals (95%CI). Results: Ten studies (1014 patients) were included. The rates of stent migration were significantly lower after fixation [OR=0.20 (95%CI: 0.11-0.37; I2=59%, p=0.01)]. The rates of complications were similar between the fixation and control groups [OR=0.65 (95%CI: 0.28-1.52; I2=55%, p=0.06)]. In the subgroup analysis, all anchoring techniques preserved the superiority over non-fixated stents [suturing OR= 0.23 (95%CI: 0.10-0.53); OTSC OR= 0.31 (95%CI: 0.17- 0.58); TTSC OR=0.10 (95%CI: 0.03-0.38)], however only OTSC and TTSC groups achieved non-significant heterogeneity (I2=0%, p=0.67 and p=0.73, respectively). No difference between techniques was recorded considering the migration rates. Conclusion: Esophageal stent fixation is associated with significantly lower migration rates compared to the non-fixated stents regardless type and stenting indication.

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Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Section: Sensitivity Analysismentioning

confidence: 99%

Section: Quality Assessmentmentioning

confidence: 99%

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

See 3 more Smart Citations

Success rates of fixation techniques on prevention of esophageal stent migration: a systematic review and meta-analysis

et al. 2023

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Esophageal Perforation

Fairbairn

Worrell

2023

Thoracic Surgery Clinics

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The Unhappy Gastric Conduit: A Medical Perspective

Codipilly

Snyder

2022

Foregut: The Journal of the American Foregut Society

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The gastric conduit is commonly created after esophagectomy to restore intestinal continuity. In this review, we discuss several complications that can arise and can be managed by a gastroenterologist. We highlight endoscopic management of anastomotic leaks and strictures. We also describe the work up and management of reflux disease, delayed gastric conduit emptying, and dumping syndrome, all of which can complicate short- and long-term outcomes in patients receiving a gastric conduit.

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The addition of flexible endoscopic suturing to stenting for the management of transmural esophageal wall defects: a single tertiary center experience

Cited by 3 publications

References 20 publications

Success rates of fixation techniques on prevention of esophageal stent migration: a systematic review and meta-analysis

Success rates of fixation techniques on prevention of esophageal stent migration: a systematic review and meta-analysis

Esophageal Perforation

The Unhappy Gastric Conduit: A Medical Perspective

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