Esophageal stents: Benign

Abstract

Self-expandable metal stents (SEMS) were first introduced for palliation of malignant dysphagia and malignant tracheoesophageal fistula. Initially bare-wire (uncovered) SEMS were used but evolved to partially then fully covered SEMS. It became apparent that covered SEMS could be removed and thus temporarily inserted to treat benign esophageal diseases. A self-expandable plastic stent is also available and removable and used to treat benign disease. Most recently, biodegradable self-expandable stents have become available and are designed so that removal is not required. The main indications for placement of self-expandable esophageal stents for benign disease include strictures, leaks, fistulae, and perforation. Less common uses include treatment refractory esophageal variceal bleeding and treatment of achalasia. In this chapter, the outcomes and complications for each stent type for each indication will be reviewed.