Esophageal prostheses

Abstract

This chapter describes the esophageal stents currently used for malignant and benign conditions. Self-expandable metal stents (SEMS) have become the most used endoprostheses for palliation of malignant dysphagia due to esophageal-esophagogastric junction cancer and mediastinal malignancy. Stents have also been proved effective in the management of esophagorespiratory fistula (ERF), anastomotic leaks, and ruptures. They allow early resumption of an almost normal diet. However, SEMS are associated with early and late complications that in some instances may be fatal. The Food and Drug Administration (FDA) has approved a self-expanding plastic stent (SEPS), because of its easy removal, for benign disease. The role of SEMS in benign strictures is challenging and sometimes risky, but experience in this field, although encouraging, is limited. Currently, several types of SEMS, including a reabsorbable type, are marketed, but no randomized studies comparing them are available. Migration, benign or malignant overgrowth, and easy removal remain unsolved problems.