Clinical outcomes, quality of life, advantages and disadvantages of metal stent placement in the upper gastrointestinal tract.
OBJECTIVE
This review will discuss the immediate- and long-term success, complications and overall benefits of self-expandable metal stents (SEMSs) in malignant or benign obstruction of the oesophagus, stomach and duodenum. Over recent years, indications such as benign disease have expanded, as has SEMS diversity with self-expandable plastic stents (SEPSs) or fully covered and biodegradable stents, for example.


RESULTS
SEMSs have been increasingly used in malignant upper gastrointestinal obstruction with many reports confirming efficacy, despite a significant complication rate. Fully covered stents are increasingly used for a variety of benign oesophageal disease, but their place in gastric outlet obstruction is still unclear. Covered and uncovered stents have different functional characteristics and stent type must be selected on an individual basis. Biodegradable stents show promise and the outcome of experience in larger patient cohorts is eagerly awaited.


CONCLUSIONS
This area is an evolving field, in which the clinician requires up-to-date knowledge of therapeutic options to make individualized treatment choices in difficult clinical circumstances. Technical and clinical success for oesophageal or gastroduodenal SEMSs are then above 90%. Minor complications are common, but serious complications seldom occur. Biodegradable stents may be useful, especially when stenting is needed for a short period of time.
Imperial College Healthcare Trust, London, UK. Panagiotis.vlavianos@imperial.nhs.uk
Panagiotis
P
Vlavianos
Abigail
A
Zabron
D004378:Duodenal Diseases / Q000628:therapy*; D004935:Esophageal Diseases / Q000628:therapy; D004940:Esophageal Stenosis / Q000628:therapy*; D017219:Gastric Outlet Obstruction / Q000628:therapy; D006801:Humans; D011788:Quality of Life / Q000523:psychology*; D015607:Stents; D013272:Stomach Diseases / Q000628:therapy*; D013997:Time Factors; D041742:Upper Gastrointestinal Tract / Q000473:pathology*