S1308 Success Rates of Fixation Techniques on Esophageal Stent Migration: A Systematic Review and Meta-Analysis
Bibliographic record
Abstract
Introduction: Esophageal stenting (ES) for benign and malignant diseases of the esophagus are an important intervention for the management of dysphagia. Stent migration represents a common drawback for this procedure. This systematic review with meta-analysis aimed to assess the benefit of ES fixation over non-fixated stenting. Methods: A systematic research was performed in MEDLINE, Cochrane, Scopus and ClinicalTrials.gov databases until January 2023 for comparative studies evaluating the migration rates of ES after anchoring or not. Quality assessment was based on the Newcastle-Ottawa Scale. The primary outcome included the relative difference of migration rates for fixated and non-fixated ES, with the rate of adverse events being the secondary outcome. A subgroup analysis was conducted to stratify the results based on different fixation techniques; suturing, over the scope clipping (OTSC) and trough the scope clipping (TTSC). We performed meta-analyses using a random effects model and the results were reported as odds ratios (OR), with 95% Confidence Intervals (95%CI). Results: Ten studies (1014 patients) were included to our analysis. The rates of self-expandable metal stent (SEMS) migration were significantly lower after fixation with an OR=0.20 (95%CI: 0.11-0.37; I2=59%). With regard to the secondary outcome, the rates of adverse events were similar between the fixation and control groups [OR=0.65 (95%CI: 0.28-1.52; I2=55%)], and no death related to the procedure was recorded. In the subgroup analysis, all anchoring techniques preserved the superiority over non-fixated stents [suturing OR= 0.23 (95%CI: 0.10-0.53); OTSC OR= 0.31 (95%CI: 0.17- 0.58); TTSC OR=0.10 (95%CI: 0.03-0.38)], however only OTSC and TTSC groups achieved non-significant heterogeneity (I2=0%). No difference between techniques was recorded considering the migration rates (Figure 1). Conclusion: Esophageal stent fixation is associated with significantly lower migration and low complication rates compared to the non-fixated SEMS regardless its type and stenting indication.Figure 1.: Forest plot reporting the odds ratios of migration rates between fixated and non-fixated esophageal stents.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.013 | 0.030 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.017 | 0.041 |
| Bibliometrics | 0.007 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".