Pron G, Common A, Simons M, Ho CS; International Society of Technology Assessment in Health Care. Meeting.
Annu Meet Int Soc Technol Assess Health Care Int Soc Technol Assess Health Care Meet. 1998; 14: 101.
Department of Medical Imaging, University of Toronto, Ontario, Canada.
OBJECTIVE: The intent of this systematic overview was to determine the clinical role of metal stents in nonvascular health care interventions and the level of evidence supporting their use. METHOD: Structured searches of Medline were conducted and limited to original, peer reviewed articles published in English. RESULTS: Clinical practice involving metal stents was reported in over 109 clinical series (mainly European), involving 4,753 patients. Randomized trial evidence was limited. Six randomized trials have been reported, all are European and involve metal stents for palliative intervention of biliary (3 trials, 268 patients) and esophageal (3 trials, 137 patients) malignant obstruction. For biliary obstruction, all three trials found metal stent palliation superior to plastic stents based on longer patency and lower reintervention costs. Safety and complication differences, however, were inconsistent across trials. For esophageal obstruction, metal stent palliation was superior to plastic stents based on lower complication and reintervention rates; and superior to laser therapy, based on better dysphagia relief. CONCLUSION: Further trials are needed to confirm the safety of metal stents and their cost-effectiveness in other than European clinical settings. Successful palliative intervention for malignant obstruction, represents an opportunity to significantly impact on quality of life for cancer patients.
Publication Types:
Keywords:
- Cost-Benefit Analysis
- Deglutition Disorders
- Humans
- Metals
- Radiology, Interventional
- Stents
- classification
- economics
- surgery
- hsrmtgs
Other ID:
UI: 102237116
From Meeting Abstracts