Self-Expandable Metallic Stent Placement for the Palliation of Esophageal Cancer

Abstract

Esophageal stents have been used to palliate patients with dysphagia caused by esophageal cancer. Early rigid plastic prostheses have been associated with a high risk of complications. However, with the development of self-expanding stents, it has developed into a widely accepted method for treating malignant esophageal strictures and esophagorespiratory fistulas (ERFs). The present review covers various aspects of self-expanding metallic stent placement for palliating esophageal cancer, including its types, placement procedures, indications, contraindications, complications, and some of innovations that will become available in the future.

Comparison of fully-covered vs partially covered self-expanding metallic stents for palliative treatment of inoperable esophageal malignancy: a systematic review and meta-analysis

“…In addition to stent related factors, patient compliance is important to prevent food obstruction. Clear and specific instruction to patients on having liquids between meals to flush the food and through chewing of food helps reduce the rate of food impaction [4]. For other complications, data only for chest pain and bleeding was pooled in our analysis.…”

“…Over the past few decades, endoscopically placed self-expandable metallic stents (SEMS) have become a treatment of choice for palliative management [3]. SEMS consist of a cylindrical metallic frame that exerts a selfexpansive force until it reaches its maximum fixed diameter [4]. It thereby expands the narrowed esophageal passage, rapidly restoring luminal patency, maintaining nutritional intake and improving quality of life [5].…”

“…Another advantage is that FCSEMS can be easily removed under endoscopic and/or fluoroscopic guidance. However, the lack of embedding in the esophageal wall makes them prone to migration as compared to uncovered stents [4]. To derive benefits of both uncovered SEMS and FCSEMS, partially covered SEMS (PCSEMS) were designed [8].…”

Comparison of Fully-Covered vs Partially Covered Self-Expanding Metallic Stents for Palliative Treatment of Inoperable Esophageal Malignancy: A Systematic Review and Meta-Analysis

“…Over the past few decades, endoscopically placed selfexpandable metallic stents (SEMS) have become a treatment of choice for palliative management [3]. SEMS consist of a cylindrical metallic frame that exerts a self-expansive force until it reaches its maximum fixed diameter [4]. It thereby expands the narrowed esophageal passage, rapidly restoring luminal patency, maintaining nutritional intake and improving quality of life [5].…”

Eventos adversos das próteses metálicas autoexpansíveis esofágicas em pacientes com doença maligna avançada e sobrevida superior a 6 meses

“…Atualmente todas as PMAEs disponíveis são fabricadas com fios de nitinol, uma liga de níquel e titânio conhecida por suas propriedades de memória e elasticidade, representando grande avanço em relação às próteses plásticas e de aço inoxidável para a paliação de neoplasias (Kim et al, 2017). Essa tecnologia também é aplicada para paliação de lesões no esôfago cervical, onde o implante da prótese pode ser desafiador.…”