食管支架（ES）是治疗恶性和良性吞咽困难的重要干预措施，但支架迁移是常见的缺点。本系统回顾及荟萃分析旨在评估ES固定与非固定支架的优势。我们在MEDLINE、Cochrane、Scopus和ClinicalTrials.gov数据库进行了系统的研究，截止到2023年1月，收集了评估锚定和非锚定支架迁移率的比较研究。主要结局包括固定和非固定ES的迁移率差异，次要结局为不良事件率。亚组分析根据不同的固定技术进行了分层，其中包括缝合、超范围夹持（OTSC）和通过范围夹持（TTSC）。荟萃分析基于随机效应模型，并以赔率比（OR）和95%置信区间（95% CI）报告结果。共纳入了10项研究（1014例患者）。锚定后，支架迁移率明显降低[OR=0.20（95% CI：0.11-0.37；I2=59%，p=0.01）]。固定组和对照组的并发症率相似[OR=0.65（95% CI：0.28-1.52；I2=55%，p=0.06）]。在亚组分析中，所有的锚定技术相对于非固定支架均保持了优势 [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）]，然而只有OTSC组和TTSC组的异质性达到了非显著水平（I2=0%，p=0.67和p=0.73）。在考虑迁移率时，各种技术之间没有差异。食管支架固定与非固定支架相比，无论类型和支架适应症，迁移率显著降低。Thieme.版权所有。

Esophageal stenting (ES) is an important intervention for the management of malignant and benign dysphagia, with migration representing a common drawback. This systematic review with meta-analysis aimed to assess the benefit of ES fixation over non-fixated stenting.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. The primary outcome included the difference of migration rates for fixated and non-fixated ES, with the rate of adverse events being secondary outcome. A subgroup analysis stratified the results based on different fixation techniques; suturing, over the scope clipping (OTSC) and trough the scope clipping (TTSC). Meta-analyses were based on random effects model and the results were reported as odds ratios (OR), with 95% Confidence Intervals (95%CI).Ten studies (1014 patients) were included. The rates of stent migration were significantly lower after fixation [OR=0.20 (95%CI: 0.11-0.37; I2=59%, p=0.01)]. The rates of complications were similar between the fixation and control groups [OR=0.65 (95%CI: 0.28-1.52; I2=55%, p=0.06)]. 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%, p=0.67 and p=0.73, respectively). No difference between techniques was recorded considering the migration rates.Esophageal stent fixation is associated with significantly lower migration rates compared to the non-fixated stents regardless type and stenting indication.Thieme. All rights reserved.