ReviewFrontiers in surgery2026
Gastric tube placement through the drainage channel of second-generation supraglottic airway devices: a systematic review with evidence mapping.
Review in Frontiers in surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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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.
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0 citing papers in PubMed.
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Authors and funding
2 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Background: Second-generation supraglottic airway (SGA) devices incorporate a dedicated gastric drainage channel that permits placement of a gastric tube (GT), but whether GT placement should be used routinely during general anaesthesia remains uncertain. We conducted a systematic review with evidence mapping to characterize the available evidence and its clinical interpretation across scenarios. Methods: MEDLINE, Embase, CENTRAL, Web of Science, and Scopus were searched from inception to 18 April 2026 (PROSPERO: CRD420261368854). A prespecified three-tier framework separated direct comparative studies of GT placement versus non-placement (Tier 1) from indirect clinical evidence (Tier 2) and complementary mechanistic or practice-based evidence (Tier 3). Risk of bias was appraised using design-appropriate tools, and GRADE was applied to five prespecified clinical outcomes. Narrative synthesis followed SWiM guidance, and an interpretive scenario-based framework was derived from the synthesis. Results: Thirty-six studies were included: 2 Tier 1, 33 Tier 2, and 1 Tier 3 study. Across the 35 clinical studies, 4,469 adults contributed data. Tier 1 evidence was limited: Hell et al. reported gastric insufflation in 10.9% of patients with a GT versus 2.7% without ( Conclusion: Current evidence is most consistent with a scenario-dependent interpretation of GT placement through the drainage channel of second-generation SGAs, rather than routine universal placement or universal avoidance; the available sample sizes were insufficient to exclude clinically important differences in rare safety outcomes. Direct GT-strategy trials are needed in underrepresented scenarios. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=1368854, identifier CRD420261368854.
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