Data_Sheet_1_Utility and safety of airway stenting in airway stenosis after lung transplant: A systematic review.docx

BackgroundAirway complications seriously affect the clinical outcomes and long-term prognosis of lung-transplantation patients. Airway stenting provides effective palliation for patients with airway stenosis. However, a lack of consensus regarding the efficacy and safety of airway stents in airway stenosis after lung transplantation. This study critically evaluated all available evidence regarding this concern.
MethodsWe retrieved studies from EMBASE, PubMed, and Cochrane Library databases. Studies were included if they reported baseline characteristics of airway complications after lung transplantation, stenting for airway stenosis, or prognosis.
ResultsIn total, 279 papers were screened and 17 papers were included in final analysis. The short-term efficacy of airway stenting was assessed in almost all studies, with immediate palliation in symptom and improved pulmonary function reported. Eleven of the included studies evaluated the long-term efficacy of stent therapy, with no distinct lung function. The median overall survival time was 1,124 (95% confidence interval 415–1,833) days in stented patients only. Stent-related complications are common regardless of the material; However, serious complications are rare and can be improved with routine management.
ConclusionWe demonstrated that airway stenting is a safe and effective method to treat airway stenosis after lung transplantation. The short-term effect was significant, while the long-term efficacy on survival rate needed further investigations.
Systematic review registrationwww.crd.york.ac.uk/prospero/, identifier: CRD42022364427.

研究背景
气道并发症（airway complications）严重影响肺移植（lung transplantation）患者的临床结局与长期预后。气道支架置入术（airway stenting）可对气道狭窄（airway stenosis）患者提供有效的姑息治疗，但目前对于肺移植术后气道狭窄患者使用气道支架的疗效与安全性尚未达成共识。本研究针对该问题对所有可获取的证据进行了系统性评价。

研究方法
我们从EMBASE、PubMed及Cochrane Library数据库中检索相关研究。纳入标准为：研究需报告肺移植术后气道并发症、气道狭窄支架置入术的基线特征或预后相关数据。

研究结果
本研究共筛选出279篇文献，最终纳入17篇进行最终分析。几乎所有纳入研究均评估了气道支架置入术的短期疗效，结果显示患者症状可即刻得到缓解，肺功能得到改善。其中11项研究评估了支架治疗的长期疗效，但未观察到肺功能存在显著改善。仅接受支架置入术的患者中位总生存期为1124天（95%置信区间：415~1833天）。无论采用何种支架材质，支架相关并发症均较为常见；但严重并发症发生率较低，且可通过常规处理得到改善。

研究结论
本研究证实，气道支架置入术是治疗肺移植术后气道狭窄的安全有效手段。其短期疗效显著，但对生存率的长期疗效仍需进一步开展研究。

本系统评价（systematic review）注册信息：www.crd.york.ac.uk/prospero/，注册号：CRD42022364427。