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Evidence summaries

Expandable Metal Stents Vs Plastic Tubes for Inoperable Oesophageal Cancer

Metal stents appear to be more safe than plastic tubes for inoperable oesophageal cancer. Level of evidence: "B"

A systematic review 1 including 6 studies with a total of 277 subjects was abstracted in DARE. One study showed significantly greater improvement in dysphagia with self-expanding metal stents (SEMs) at 1 week (P=0.04), but not at 6 weeks. Life-threatening procedural complications (6 studies): There was a significantly lower risk of perforation or haemorrhage among patients randomised to SEMs than to plastic tubes (RR 0.40, 95% CI: 0.19 to 0.81). Procedure-related mortality (4 studies): There was a significantly lower risk of death among patients randomised to SEMs than to plastic tubes (RR 0.22, 95% CI: 0.07 to 0.75). Device migration (4 studies): There was no significant difference between SEMs and plastic tubes (RR 0.48, 95% CI: 0.22 to 1.05; result in favour of SEMs). Food impaction (6 studies): There was no significant difference between SEMs and plastic tubes (RR 0.64, 95% CI: 0.30 to 1.35; result in favour of SEMs).

Comment: The quality of evidence is downgraded by imprecise results (limited study size for each comparison).

    References

    • Gajraj R, Moore D, Jones B, Song F. Expandable metal stents for inoperable oesophageal cancer. Birmingham: University of Birmingham , Department of Public Health and Epidemiology, 2002. [DARE]

Primary/Secondary Keywords