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Meta-Analysis
. 2023 Apr;37(4):2476-2484.
doi: 10.1007/s00464-022-09767-w. Epub 2022 Dec 8.

SX-ELLA biodegradable stent for benign oesophageal strictures: a systematic review and proportion meta-analysis

Elisha Kailla  1   2 , Fatema Rezai  1 , Ange Kamille Kansci  2 , Oluwadamilola Akande  2 , James Gossage  3
Affiliations
Meta-Analysis

SX-ELLA biodegradable stent for benign oesophageal strictures: a systematic review and proportion meta-analysis

Elisha Kailla et al. Surg Endosc. 2023 Apr.

Abstract

Background: This systematic review aimed to analyse the use of the SX-ELLA biodegradable stent (BDS) for benign oesophageal strictures through the assessment of clinical and technical success, differences in pre- and post-BDS insertion dysphagia scores, rates of stent migration, and safety.

Methods: A systematic review was reported according to PRISMA guidelines, with a prospectively registered protocol. The databases PubMed, Embase, SCOPUS, and ClinicalTrials.gov were searched up to March 2022. Studies assessing the use of the SX-ELLA BDS in adults with benign oesophageal strictures were included. A pooled data analysis was conducted to analyse the clinical and technical success associated with BDS use, rate of stent migration, and safety.

Results: Of the 1509 articles identified, 16 studies treating 246 patients were eligible for inclusion. BDS was clinically successful in 41.9% of cases (95% CI = 35.7 - 48.1%), defined as those who experienced complete symptom resolution following BDS insertion. Technical success was achieved in 97.2% of patients (95% CI = 95.1 - 99.3%). A pooled analysis concluded a decrease in mean dysphagia score of 1.8 points (95% CI = 1.68 - 1.91) following BDS insertion. Re-intervention was required in 89 patients (36.2%, 95% CI = 30.2 - 42.2%), whilst stent migration occurred in 6.5% of patients (95% CI = 3.4 - 9.6%). A total of 37 major clinical complications related to BDS insertion were reported (15.0%, 95% CI = 10.5 - 19.5%).

Conclusion: The pooled data analysis demonstrates the high technical and moderate clinical success of the SX-ELLA biodegradable stent, supporting its use for benign oesophageal strictures in adults. However, greater evidence is required for more robust conclusions to be made in terms of success when compared to alternative methods of intervention, such as endoscopic dilation.

Keywords: Absorbable implants; Adults; Benign oesophageal stricture; Biodegradable stent; Health technology assessment; Oesophageal stenosis.

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Conflict of interest statement

Miss Elisha Kailla, Miss Fatema Rezai, Mr James Gossage, Miss Ange Kamille Kansci, and Miss Oluwadamilola Akande have no conflicts of interest or financial ties to disclose.

Figures

Fig. 1
Fig. 1
A Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) flow diagram
See this image and copyright information in PMC

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