{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T13:23:00Z","timestamp":1773408180793,"version":"3.50.1"},"reference-count":32,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2008,7,3]],"date-time":"2008-07-03T00:00:00Z","timestamp":1215043200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2008,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The type of stent used for the management of patients with malignant dysphagia is chosen according to subjective physician\u2019s preference. There is no recent study available to provide updated evidence on early outcomes related to the use of different types of stents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A literature search was performed using Embase, MEDLINE, Cochrane Library, and Google Scholar databases for comparative studies assessing different types of stents. The primary end point was stent\u2010related mortality; secondary end points included: stent\u2010related morbidity, successful palliation of dysphagia, and 30\u2010day mortality. A random\u2010effects model was used and heterogeneity was assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twelve studies that included 911 patients compared metallic (46.54%) and plastic stents (53.45%), and eight studies that included 564 patients compared covered (43.26%) and uncovered metal stents (56.73%). Meta\u2010analysis of randomized, controlled trials showed that metallic stents were associated with significantly reduced stent\u2010related mortality (1.7% vs. 11.1% for the plastic group, odds ratio (OR), 0.2; 95% confidence interval (CI), 0.06\u20130.74;\n                      <jats:italic>P<\/jats:italic>\n                      = 0.02), morbidity in the form of reduced esophageal perforation (1.4% vs. 9.4% for plastic stent, OR, 0.27; 95% CI, 0.08\u20130.89;\n                      <jats:italic>P<\/jats:italic>\n                      = 0.03), and stent migration, yet increased rate of tumor in\u2010growth (13% vs. 1.6% for plastic stents, OR, 4.84; 95% CI, 0.99\u201323.76;\n                      <jats:italic>P<\/jats:italic>\n                      = 0.05). Covered metallic stents had significantly less tumor in\u2010growth than the uncovered and an increased migration rate. There was no significant difference between metallic and plastic stents in terms of any other stent\u2010related morbidity and 30\u2010day mortality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Self\u2010expanding metallic stents are superior to plastic stents in terms of stent insertion\u2010related mortality, morbidity, and quality of palliation. The uncovered variety is disadvantaged by high rate of tumor in\u2010growth; adequately designed randomized, controlled trials need to examine outcomes and cost\u2010effectiveness of covered versus uncovered metallic stents.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00268-008-9654-1","type":"journal-article","created":{"date-parts":[[2008,7,1]],"date-time":"2008-07-01T19:05:33Z","timestamp":1214939133000},"source":"Crossref","is-referenced-by-count":35,"title":["Evidence\u2010Based Choice of Esophageal Stent for the Palliative Management of Malignant Dysphagia"],"prefix":"10.1002","volume":"32","author":[{"given":"Danny","family":"Yakoub","sequence":"first","affiliation":[{"name":"Imperial College of Science, Technology and Medicine, Department of Bio\u2010surgery and Surgical Technology St Mary\u2019s Hospital W2 1NY London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramy","family":"Fahmy","sequence":"additional","affiliation":[{"name":"Imperial College of Science, Technology and Medicine, Department of Bio\u2010surgery and Surgical Technology St Mary\u2019s Hospital W2 1NY London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thanos","family":"Athanasiou","sequence":"additional","affiliation":[{"name":"Imperial College of Science, Technology and Medicine, Department of Bio\u2010surgery and Surgical Technology St Mary\u2019s Hospital W2 1NY London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Afshin","family":"Alijani","sequence":"additional","affiliation":[{"name":"Imperial College of Science, Technology and Medicine, Department of Bio\u2010surgery and Surgical Technology St Mary\u2019s Hospital W2 1NY London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Rao","sequence":"additional","affiliation":[{"name":"Imperial College of Science, Technology and Medicine, Department of Bio\u2010surgery and Surgical Technology St Mary\u2019s Hospital W2 1NY London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ara","family":"Darzi","sequence":"additional","affiliation":[{"name":"Imperial College of Science, Technology and Medicine, Department of Bio\u2010surgery and Surgical Technology St Mary\u2019s Hospital W2 1NY London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George B.","family":"Hanna","sequence":"additional","affiliation":[{"name":"Imperial College of Science, Technology and Medicine, Department of Bio\u2010surgery and Surgical Technology St Mary\u2019s Hospital W2 1NY London UK"},{"name":"Department of Surgical Oncology and Technology St Mary\u2019s Hospital 10th Floor, QEQM Building, Praed Street W2 1NY London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2008,7,3]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1067\/mge.2001.116879"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199310283291803"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1067\/mge.2001.116626"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/gut.50.suppl_5.v1"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.3310\/hta9050"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.1.6062.714"},{"key":"e_1_2_6_8_2","volume-title":"The Cochrane Library, Issue 3","author":"Clarke M","year":"2001"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1159\/000055014"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/0197\u20102456(86)90046\u20102"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7109.629"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.311.7007.753c"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0016\u20105107(98)70342\u20106"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-1004293"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5107(96)70290-0"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1442\u20102050.2003.00308.x"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1093\/dote\/11.3.172"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1097\/00042737\u2010199809000\u201000004"},{"key":"e_1_2_6_19_2","first-page":"394","article-title":"Palliation of dysphagia from inoperable oesophageal carcinoma using Atkinson tubes or self\u2010expanding metal stents","volume":"80","author":"Davies N","year":"1998","journal-title":"Ann R Coll Surg Engl"},{"key":"e_1_2_6_20_2","first-page":"640","article-title":"Palliative treatment of oesophageal carcinoma\u2013efficacy of plastic versus self\u2010expandable stents","volume":"89","author":"Sanyika C","year":"1999","journal-title":"S Afr Med J"},{"key":"e_1_2_6_21_2","first-page":"653","article-title":"Metal stents improve dysphagia, nutrition and survival in malignant oesophageal stenosis: a randomized controlled trial comparing modified Gianturco Z\u2010stents with plastic Atkinson tubes","volume":"10","author":"Roseveare CD","year":"1998","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"e_1_2_6_22_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365\u20102168.2002.02152.x"},{"key":"e_1_2_6_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0016\u20105107(96)70316\u20104"},{"key":"e_1_2_6_24_2","first-page":"331","article-title":"Oesophageal self expanding metal stents. Preliminary report about covered and non\u2010covered types","volume":"63","author":"De Ronde T","year":"2000","journal-title":"Acta Gastroenterol Belg"},{"key":"e_1_2_6_25_2","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v11.i3.451"},{"key":"e_1_2_6_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0720\u2010048X(02)00154\u20107"},{"key":"e_1_2_6_27_2","first-page":"1496","article-title":"Coated and uncoated self\u2010expanding metal stents for malignant stenosis in the upper GI tract: preliminary clinical experiences with Wallstents","volume":"89","author":"Ell C","year":"1994","journal-title":"Am J Gastroenterol"},{"key":"e_1_2_6_28_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442\u20102050.2005.00484.x"},{"key":"e_1_2_6_29_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572\u20100241.2001.03923.x"},{"key":"e_1_2_6_30_2","doi-asserted-by":"publisher","DOI":"10.1097\/00042737\u2010199805000\u201000003"},{"key":"e_1_2_6_31_2","doi-asserted-by":"publisher","DOI":"10.1097\/00004836\u2010199606000\u201000004"},{"key":"e_1_2_6_32_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00455\u2010003\u20100018\u20106"},{"key":"e_1_2_6_33_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.279.14.1089"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-008-9654-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00268-008-9654-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00268-008-9654-1","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,26]],"date-time":"2023-12-26T14:36:15Z","timestamp":1703601375000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00268-008-9654-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,7,3]]},"references-count":32,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2008,9]]}},"alternative-id":["10.1007\/s00268-008-9654-1"],"URL":"https:\/\/doi.org\/10.1007\/s00268-008-9654-1","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.1120775.577024","asserted-by":"object"}]},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2008,7,3]]},"article-number":"1996"}}