Clin Endosc.  2014 Jul;47(4):295-300. 10.5946/ce.2014.47.4.295.

Plastic and Biodegradable Stents for Complex and Refractory Benign Esophageal Strictures

• Ham YH
• Kim GH

• KMID: 1907927
• DOI: http://doi.org/10.5946/ce.2014.47.4.295

Abstract

Endoscopic stent placement is a well-accepted and effective alternative treatment modality for complex and refractory esophageal strictures. Among the currently available types of stents, the partially covered self-expanding metal stent (SEMS) has a firm anchoring effect, preventing stent migration and ensuring effective covering of a narrowed segment. However, hyperplastic tissue reaction driven by the uncovered mesh may prevent easy and safe stent removal. As an alternative, a fully covered SEMS decreases the recurrence of dysphagia caused by hyperplastic tissue ingrowth; however, it has a high migration rate. Likewise, although a self-expanding plastic stent (SEPS) reduces reactive hyperplasia, the long-term outcome is disappointing because of the high rate of stent migration. A biodegradable stent has the main benefit of not requiring stent removal in comparison with SEMS and SEPS. However, it still has a somewhat high rate of hyperplastic reaction, and the long-term outcome does not satisfy expectations. Up to now, the question of which type of stent should be recommended for the effective treatment of complex and refractory benign strictures has no clear answer. Therefore, the selection of stent type for endoscopic treatment should be individualized, taking into consideration the endoscopist's experience as well as patient and stricture characteristics.

Keyword

Stricture; Esophagus; Stents; Endoscopic treatment

MeSH Terms

Constriction, Pathologic*
Deglutition Disorders
Esophagus
Humans
Hyperplasia
Plastics*
Recurrence
Stents*
Plastics

Figure

• 

  Fig. 1 Stents currently used for benign esophageal strictures. (A)Niti-S covered stent (Taewoong Medical). (B) Polyflex stent (Boston Scientific). (C) ELLA-BD stent (ELLA-CS).

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