Endoprosthetics in the treatment of benign esophageal strictures

Alessandro Repici, Chiara Genco, Ivana Bravata`, Andrea Anderloni

Research output: Contribution to journalArticlepeer-review

Abstract

Benign esophageal strictures are a common problem in endoscopic practice. The predominant symptom of patients is dysphagia. The initial treatment option for a benign esophageal stricture is dilation. A small subgroup of strictures, that is, those that are long (>2. cm), are tortuous, and have a narrow diameter, or are associated with caustic or postradiotherapy etiology, tend to recur and are therefore called refractory. Temporary stent placement, with either a self-expandable metal stent or a self-expandable plastic stent, can be considered as a treatment option in these patients. From a technical point of view, placement of an expandable stent in benign strictures does not differ from placement in cases of palliation of malignant dysphagia. Deep sedation and careful stent placement, especially in proximal locations, is extremely important. Results of temporary stenting are still inconclusive; long-term clinical resolution of the stricture is achieved in less than 50% of patients. Moreover long-term data on safety and efficacy are scant. These disappointing results are mainly because of hyperplastic tissue ingrowth or overgrowth and stent migration. New stent designs are needed for this indication. Promising initial results show that biodegradable stents may be useful for refractory benign esophageal strictures; however, these preliminary data need to be further elucidated in future studies.

Original languageEnglish
Pages (from-to)71-78
Number of pages8
JournalTechniques in Gastrointestinal Endoscopy
Volume16
Issue number2
DOIs
Publication statusPublished - Apr 1 2014

Keywords

  • Biodegradable stent
  • Refractory benign esophageal stricture
  • Self-expandable esophageal metal stent
  • Self-expandable esophageal plastic stent
  • Stent migration and removal

ASJC Scopus subject areas

  • Gastroenterology
  • Radiology Nuclear Medicine and imaging

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