title: Esophageal Stent for Refractory Variceal Bleeding: A Systemic Review and Meta-Analysis.
abstract: Background. Preliminary studies suggest that covered self-expandable metal stents may be helpful in controlling esophageal variceal bleeding. Aims. To evaluate the effectiveness and safety of esophageal stent in refractory variceal bleeding in a systematic review and meta-analysis. Methods. A comprehensive literature search was conducted on PubMed, EMBASE, and Cochrane Library covering the period from January 1970 to December 2015. Data were selected and abstracted from eligible studies and were pooled using a random-effects model. Heterogeneity was assessed using I (2) test. Results. Five studies involving 80 patients were included in the analysis. The age of patients ranged from 18 to 91 years. The mean duration of follow-up was 46.8 d (range, 30-60 d). The success rate of stent deployment was 96.7% (95% CI: 91.6%-99.5%) and complete response to esophageal stenting was in 93.9% (95% CI: 82.2%-99.6%). The incidence of rebleeding was 13.2% (95% CI: 1.8%-32.8%) and the overall mortality was 34.5% (95% CI: 24.8%-44.8%). Most of patients (87.4%) died from hepatic or multiple organ failure, and only 12.6% of patients died from uncontrolled bleeding. There was no stent-related complication reported and the incidence of stent migration was 21.6% (95% CI: 4.7%-46.1%). Conclusion. Esophageal stent may be considered in patients with variceal bleeding refractory to conventional therapy.
authors: Department of Gastroenterology, General Hospital of Shenyang Military Area Command, Shenyang 110016, China.
authors: Xiao-Dong
authors: 0000-0002-7693-2969
authors: XD
authors: Shao
authors: Department of Gastroenterology, General Hospital of Shenyang Military Area Command, Shenyang 110016, China.
authors: Xing-Shun
authors: 0000-0002-9448-6739
authors: XS
authors: Qi
authors: Department of Gastroenterology, General Hospital of Shenyang Military Area Command, Shenyang 110016, China.
authors: Xiao-Zhong
authors: XZ
authors: Guo
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D004932:Esophageal and Gastric Varices / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery*; D019317:Evidence-Based Medicine; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality*; D015995:Prevalence; D012307:Risk Factors; D017678:Sex Distribution; D015607:Stents / Q000706:statistics & numerical data*; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult