SynthesisInternational journal of medical sciences2013
A systematic review and meta-analysis of randomized trials and prospective studies comparing covered and bare self-expandable metal stents for the treatment of malignant obstruction in the digestive tract.
Synthesis in International journal of medical sciences, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04810377 (Safety and Efficacy of Endoscopic Ultrasound-Guided Gastroenterostomy for the Treatment of Malignant Gastric Outlet Obstruction), which is not on this map. Cited by 36 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Safety and Efficacy of Endoscopic Ultrasound-Guided Gastroenterostomy for the Treatment of Malignant Gastric Outlet Obstruction
Who cites it
36 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Methodological overview of systematic reviews to establish the evidence base for emergency general surgery.The British journal of surgery · 2017Pooled it
- Covered versus uncovered self-expandable metallic stents for palliation of malignant gastric outlet obstruction: a systematic review and meta-analysis.BMC gastroenterology · 2014Pooled it
- Covered versus uncovered endoluminal stenting in the acute management of obstructing colorectal cancer in the palliative setting: randomized clinical trial (CReST2).The British journal of surgery · 2025Trial
- Comparison of different types of covered self-expandable metal stents for malignant colorectal obstruction.Surgical endoscopy · 2021Trial
- Endoscopic treatment of Crohn-related strictures with a self-expandable stent compared with balloon dilation: a prospective, randomised, controlled study.BMJ open gastroenterology · 2021Trial
- Partially covered or uncovered metal stent efficacy in malignant unresectable distal biliary obstruction (METARSI): Randomized multicenter trial.Endoscopy international open · 2026Article
- Colon stenting as a bridge to surgery in obstructive colorectal cancer management.Clinical endoscopy · 2024Review
- Factors associated with patency of self-expandable metal stents in malignant biliary obstruction.BMC gastroenterology · 2023Article
- Best Practices in Esophageal, Gastroduodenal, and Colonic Stenting.GE Portuguese journal of gastroenterology · 2023Review
- Article
- Interventional Endoscopy for Palliation of Luminal Gastrointestinal Obstructions in Management of Cancer: Practical Guide for Oncologists.Journal of clinical medicine · 2022Review
- [Palliative endoscopy].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2022Article
- Comparing the 14-mm uncovered and 10-mm covered metal stents in patients with distal biliary obstruction caused by unresectable pancreatic cancer: a multicenter retrospective study.Surgical endoscopy · 2022Article
- Factors Associated with Clinical Outcomes of Palliative Stenting for Malignant Colonic Obstruction.Gut and liver · 2021Article
- The Association of Coloproctology of Great Britain and Ireland consensus guidelines in emergency colorectal surgery.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2021Article
- Utility and Safety of a Novel Fully Covered Metal Stent in Unresectable Distal Malignant Biliary Obstruction.Digestive diseases and sciences · 2020Article
- Optimization of biliary drainage in inoperable distal malignant strictures.World journal of gastrointestinal endoscopy · 2020Article
- Management of gastric outlet obstruction: Focusing on endoscopic approach.World journal of gastrointestinal pharmacology and therapeutics · 2020Review
- Endoscopic Management of Malignant Colonic Obstruction.Clinical endoscopy · 2020Article
- Endoscopic Management of Benign Colonic Obstruction and Pseudo-Obstruction.Clinical endoscopy · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSelf-expandable metal stents (SEMS) are widely used for the palliative treatment of malignant gastrointestinal obstruction. Our aim was to evaluate the evidence comparing covered and bare SEMS in the digestive tract using meta-analytical techniques.
methodsA literature search was performed using PubMed, Cochrane Library, and Embase databases for comparative studies assessing the two types of stents. The primary outcomes of interest were stent patency and patient survival; second outcomes included technical success, clinical success, tumor ingrowth, tumor overgrowth, and stent migration. A random-effects model was conducted. Pooled analysis was done separately based on the different segments of the digestive tract.
resultsEleven studies (8 randomized controlled trials and 3 prospective cohort studies) including a total of 1376 patients were identified. Covered SEMS were equivalent to bare SEMS in terms of technical success, clinical success, stent patency (gastroduodenal obstruction: HR =0.87, 95% CI 0.53-1.42; colorectal obstruction: HR =0.89, 95% CI 0.18-4.45; biliary obstruction: HR =0.73, 95% CI 0.41-1.32) and survival rates (esophageal obstruction: HR =1.80, 95% CI 0.73-4.44; gastroduodenal obstruction: HR =0.83, 95% CI 0.55-1.26; biliary obstruction: HR =0.99, 95% CI 0.77-1.28), although bare stents were more prone to tumor ingrowth (esophageal obstruction: RR =0.10, 95% CI 0.01-0.77; gastroduodenal obstruction: RR =0.12, 95% CI 0.03-0.55; colorectal obstruction: RR =0.21, 95% CI 0.06-0.70; biliary obstruction: RR =0.21, 95% CI 0.06-0.69), whereas covered stents had the higher risk of stent migration (gastroduodenal obstruction: RR =5.01, 95% CI 1.53-16.43; colorectal obstruction: RR =11.70, 95% CI 2.84-48.27; biliary obstruction: RR =8.11, 95% CI 1.47-44.76) and tumor overgrowth (biliary obstruction: RR =2.03, 95% CI 1.08-3.78).
conclusionBoth covered and bare SEMS are comparable in efficacy for the palliative treatment of malignant obstruction in the digestive tract. Each type of the stents has its own merit and demerit relatively.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.