Enteral stents: from esophagus to colon.
Because of significant advances in endoscopic techniques and the development of high-quality stents, endoscopic enteral stent placement is increasingly being performed for the management of malignant GI obstruction. Palliative stenting is now routinely performed for malignant esophageal, gastric, duodenal, and colon obstruction. In addition to palliative indications, preoperative stenting in the colon may be performed as a bridge to surgery to achieve immediate decompression and convert an emergent surgery into an elective, 1-stage procedure.The realm of enteral stenting has recently expanded to include management of benign conditions such as leaks, fistulas, and benign strictures in the GI tract. Further research is required to study the use of enteral stents in benign conditions and to adequately compare endoscopic stent placement with surgical intervention. Promising new technologies such as biodegradable stents and drug-eluting stents also require further investigation. With continued innovation in endoscopic techniques and stenting devices, the field of enteral stenting is likely to expand further, with an increase in indications and improvement in outcomes.
Clinical Instructor, Advanced Endoscopy, Division of Gastroenterology, Stanford University School of Medicine, Palo Alto, California, USA.
Rajan
R
Kochar
Associate Chief, Division of Gastroenterology, Santa Clara Valley Medical Center, San Jose, California, USA; Clinical Instructor of Medicine, Division of Gastroenterology, Stanford University School of Medicine, Palo Alto, California, USA.
Nimeesh
N
Shah
D003108:Colonic Diseases / Q000628:therapy*; D004935:Esophageal Diseases / Q000628:therapy*; D017219:Gastric Outlet Obstruction / Q000628:therapy*; D006801:Humans; D007415:Intestinal Obstruction / Q000628:therapy*; D019919:Prosthesis Implantation / Q000009:adverse effects / Q000379:methods*; D015607:Stents / Q000009:adverse effects
FDA; Food and Drug Administration; SEMS; SEPS; self-expandable metal stent; self-expandable plastic stent