Ten studies were included in the review (total n=185, 130 treated patients, median sample size 16, range one to 40): seven retrospective studies and three prospective studies. Median follow-up after SEPS insertion was 13 months (range six to 23 months).
Effectiveness: Treatment was successful in 98% (95% CI 96% to 100%) of patients. Overall clinical success rate was 52% (95% CI 44% to 61%). A statistically significant higher level of success was reported in patients with strictures in the mid or lower oesophagus compared with the upper oesophagus (54% versus 33%). A trend for higher success was noted in patients with more than 2cm stricture length compared with those with shorter strictures (49% versus 28%). There were no other reported differences in clinical success rates.
Complications: Early stent migration was 23% (95% CI 14 to 32%; eight studies). The re-intervention rate was 21% (95% CI 14% to 28%; nine studies). Overall clinical complication rate was 9% (95% CI 4% to 14%), which comprised incidences of perforation (three cases), bleeding (three cases), tracheal compression or chest pain (two cases), inability to remove the stent (two cases), death (due to massive bleeding in one case) and tracheal fistula (one case).