Efficacy and safety of self-expandable metallic stent on benign tracheobronchial stenosis: a systematic review and meta-analysis.

Abstract

<h4>Background</h4>The safety and efficacy of self-expandable metallic stent (SEMS) in the management of benign tracheobronchial stenosis (TBS) remain elusive. This study aimed to provide comprehensive insights into the efficacy and safety of SEMS in treating benign TBS.<h4>Methods</h4>We conducted a meta-analysis to elucidate the safety and efficacy of the SEMS in benign TBS. Data on related trials were obtained by doing a literature search in PubMed, Cochrane Library, Web of Science and Embase. Random-effect models were used to calculate the efficacy and incidence of complication of SEMS treatment.<h4>Results</h4>Data of 797 participants who received 1,236 SEMS during 26.0±13.5 months of follow-up period were included and analyzed. The main causes of benign TBS included tracheotomy (32.8%), anastomotic stenosis after transplantation or lobectomy (31.3%), tracheal intubation (18.1%), and other benign diseases (17.8%). The total effective rate of SEMS in the treatment of benign TBS was 56.4%, but varied from different etiologies: iatrogenic injury 41.5%, tuberculous infection 83.3%, autoimmune disease 46.2%, and external compression 75%, respectively. The average time of stents placement was 6.59±4.96 months, while the success rate of stent removal was 98.7%. The overall incidence of complications after stent implantation was 45%, including airway restenosis 16.7%, granulation tissue hyperplasia 27.9%, mucus retention 19%, stent migration 20.1%, and stent rupture 25.7%. Airway stent-related mortality was rarely occurred.<h4>Conclusions</h4>SEMS could serve as a relatively effective and safe treatment for benign TBS with intensive observation and follow-up.