Stenting for benign esophageal strictures.
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 subgroup of strictures, i. e., those that are long (> 2 cm), tortuous, and have a narrow diameter, tend to recur and are therefore called refractory. Temporary stent placement, either with a self-expanding metal stent (SEMS) or a self-expanding plastic stent (SEPS), can be considered in these patients. The results obtained so far are disappointing, with long-term clinical resolution of the stricture achieved in less than 50 % of patients. This is mainly due to hyperplastic tissue ingrowth or overgrowth (experienced with SEMS) and stent migration (SEPS). New stent designs are therefore needed for this indication. Initial results show that biodegradable stents have the promise to be useful for refractory benign esophageal strictures; however, this promise needs to be further elucidated in future studies.
Siersema
P D
PD
Department of Gastroenterology and Hepatology, University Medical Center Utrecht, The Netherlands. p.d.siersema@umcutrecht.nl