Stenting for Advanced Esophageal Carcinoma

Abstract

Esophageal cancer is the eighth most common malignancy and the sixth leading cause of cancer-related deaths worldwide. Most patients with esophageal cancer are identified at an advanced stage of disease. Less than 20% of patients are candidates for curable surgical resection. Self-expandable metallic stents (SEMSs) have recently been used for the palliation of incurable esophageal cancer. Since their use was first reported in the late 1970s, stents have evolved rapidly from rigid plastic tubes to flexible SEMSs. This review covers various aspects of SEMS placement for advanced esophageal cancer and discusses multiple types of SEMSs, considerations in stent placement, complications, and recently developed radiation-emitting stents.

Palliation of malignant dysphagia with a segmented self-expanding metal stent

“…Even though stents can successfully reduce dysphagia, some of the common problems are migration, occlusion, and bleedings [7] . Several innovations, such as self-expandable metallic and plastic stents, different methods to cover the stent (fully covered vs partially covered vs uncovered) as well as drug eluting or radioactive stents have been introduced over the years to mitigate those problems [8–11] . Recently, segmented self-expanding metal stents (segSEMS), in which individual elements are connected by a nylon wire, have become available.…”

“…[7] Several innovations, such as self-expandable metallic and plastic stents, different methods to cover the stent (fully covered vs partially covered vs uncovered) as well as drug eluting or radioactive stents have been introduced over the years to mitigate those problems. [8][9][10][11] Recently, segmented self-expanding metal stents (segSEMS), in which individual elements are connected by a nylon wire, have become available. Due to their segmented nature and ability to bend, they promise to reduce pressure on the esophagus, offer a better fit over curved surface areas, and better adjust to esophageal peristalsis, which may result in less complications.…”