Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Sep-Oct;36(5):524-532.
doi: 10.20524/aog.2023.0819. Epub 2023 Jul 3.

Efficacy of lumen-apposing metal stents for the management of benign gastrointestinal stricture: a systematic review and meta-analysis

Suprabhat Giri  1 , Arun Vaidya  2 , Aditya Kale  2 , Vaneet Jearth  3 , Sridhar Sundaram  4
Affiliations

Efficacy of lumen-apposing metal stents for the management of benign gastrointestinal stricture: a systematic review and meta-analysis

Suprabhat Giri et al. Ann Gastroenterol. 2023 Sep-Oct.

Abstract

Background: Lumen-apposing metal stents (LAMS) are an evolving option for the management of benign gastrointestinal (GI) strictures. Multiple studies have reported on the efficacy and safety of LAMS for benign GI strictures, but were limited by their small sample size. Hence, we conducted this meta-analysis to assess the critical role of LAMS for the management of benign GI strictures.

Methods: A literature search of various databases from inception until October 2022 was conducted for studies evaluating the outcome of LAMS in patients with benign GI strictures. The outcomes assessed included technical and clinical success, adverse events including stent migration, and reintervention. Pooled event rates across studies were expressed with summative statistics.

Results: A total of 18 studies (527 patients) were included in the present analysis. The pooled event rates for technical, short-term and long-term clinical success were 99.9% (95% confidence interval [CI] 99.1-100.0), 93.9% (95%CI 90.7-100.0), and 72.8% (95%CI 55.7-90.0), respectively. The pooled incidence of adverse events and stent migration with LAMS for benign GI strictures was 13.5% (95%CI 8.6-18.5) and 10.6% (95%CI 6.0-15.2), respectively. The pooled event rate for reintervention with LAMS for GI strictures was 23.0% (95%CI 15.7-30.3). In a subgroup analysis focusing only on anastomotic strictures there was no significant difference in the pooled event rates for various outcomes.

Conclusions: LAMS have a high technical and short-term clinical success rate, with an acceptable safety profile for the management of benign GI strictures. Further studies are needed to determine the appropriate duration of stent therapy and long-term outcomes.

Keywords: Lumen-apposing metal stents; endoscopic stenting; gastrointestinal strictures; meta-analysis.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: None

Figures

Figure 1
Figure 1
PRISMA flowchart for study identification and selection process
See this image and copyright information in PMC

References

    1. Kochhar R, Kochhar S. Endoscopic balloon dilation for benign gastric outlet obstruction in adults. World J Gastrointest Endosc. 2010;2:29–35. - PMC - PubMed
    1. Pereira-Lima JC, Ramires RP, Zamin I, Jr, Cassal AP, Marroni CA, Mattos AA. Endoscopic dilation of benign esophageal strictures:report on 1043 procedures. Am J Gastroenterol. 1999;94:1497–1501. - PubMed
    1. Hirdes MM, Siersema PD, Vleggaar FP. A new fully covered metal stent for the treatment of benign and malignant dysphagia:a prospective follow-up study. Gastrointest Endosc. 2012;75:712–718. - PubMed
    1. Fujii LL, Bonin EA, Baron TH, Gostout CJ, Wong Kee Song LM. Utility of an endoscopic suturing system for prevention of covered luminal stent migration in the upper GI tract. Gastrointest Endosc. 2013;78:787–793. - PubMed
    1. Binmoeller KF, Shah J. A novel lumen-apposing stent for transluminal drainage of nonadherent extraintestinal fluid collections. Endoscopy. 2011;43:337–342. - PubMed

LinkOut - more resources