Evidence map›Paper›PMID 26487197›Full record

SynthesisSurgical endoscopy2016

Prevention of esophageal stricture after endoscopic submucosal dissection: a systematic review and meta-analysis.

J F Oliveira, E G H Moura, W M Bernardo, E Ide, S Cheng, M Sulbaran, C M L Santos, P Sakai

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Surgical endoscopy, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 2 pooled it
3.0field-weighted citation impact, top 10% of its field
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 2 syntheses or guidelines pooled it, 49 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

J F OliveiraGastrointestinal Endoscopy Unit, University of São Paulo Medical School, São Paulo, Brazil. jfoliveira1@gmail.com.
E G H MouraGastrointestinal Endoscopy Unit, University of São Paulo Medical School, São Paulo, Brazil.
W M BernardoBrazilian Medical Association (AMB), São Paulo, Brazil.
E IdeGastrointestinal Endoscopy Unit, University of São Paulo Medical School, São Paulo, Brazil.
S ChengGastrointestinal Endoscopy Unit, University of São Paulo Medical School, São Paulo, Brazil.
M SulbaranGastrointestinal Endoscopy Unit, University of São Paulo Medical School, São Paulo, Brazil.
C M L SantosGastrointestinal Endoscopy Unit, University of São Paulo Medical School, São Paulo, Brazil.
P SakaiGastrointestinal Endoscopy Unit, University of São Paulo Medical School, São Paulo, Brazil.
Universidade de São Paulo · BRBrazilian Medical Association · BR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEndoscopic submucosal dissection (ESD) of extensive superficial cancers of the esophagus may progress with high rates of postoperative stenosis, resulting in significantly decreased quality of life. Several therapies are performed to prevent this, but have not yet been compared in a systematic review.

methodsA systematic review of the literature and meta-analysis were performed using the MEDLINE, Embase, Cochrane, LILACS, Scopus, and CINAHL databases. Clinical trials and observational studies were searched from March 2014 to February 2015. Search terms included: endoscopy, ESD, esophageal stenosis, and esophageal stricture. Three retrospective and four prospective (three randomized) cohort studies were selected and involved 249 patients with superficial esophageal neoplasia who underwent ESD, at least two-thirds of the circumference. We grouped trials comparing different techniques to prevent esophagus stenosis post-ESD.

resultsWe conducted different meta-analyses on randomized clinical trials (RCT), non-RCT, and global analysis. In RCT (three studies, n = 85), the preventive therapy decreased the risk of stenosis (risk difference = -0.36, 95 % CI -0.55 to -0.18, P = 0.0001). Two studies (one randomized and one non-randomized, n = 55) showed that preventative therapy lowered the average number of endoscopy dilatations (mean difference = -8.57, 95 % CI -13.88 to -3.25, P < 0.002). There were no significant differences in the three RCT studies (n = 85) in complication rates between patients with preventative therapy and those without (risk difference = 0.02, 95 % CI -0.09 to 0.14, P = 0.68).

conclusionsThe use of preventive therapy after extensive ESD of the esophagus reduces the risk of stenosis and the number of endoscopic dilatations for resolution of stenosis without increasing the number of complications.

Indexed as

AdenocarcinomaCarcinoma, Squamous CellEndoscopic Mucosal ResectionEsophageal NeoplasmsEsophageal StenosisEsophagoscopyHumansPostoperative ComplicationsQuality of LifeEndoscopy submucosal dissectionESDEsophageal stenosisEsophageal strictureMeta-analysisSystematic review

Identifiers

PMID26487197
OpenAlexW1806445074

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.