The use of
stents for esophageal
strictures has evolved rapidly over the past 10 years, from rigid
plastic tubes to flexible self-expanding
metal (SEMS),
plastic (SEPS) and biodegradable
stents. For the
palliative treatment of malignant
dysphagia both SEMS and SEPS effectively provide a rapid relief of
dysphagia. SEMS are preferred over SEPS, as randomized controlled trials have shown more technical difficulties and late migration with
plastic stents. Despite specific characteristics of recently developed
stents, recurrent
dysphagia due to food impaction, tumoral and nontumoral tissue overgrowth, or
stent migration, remain a major challenge. The efficacy of
stents with an antireflux valve for patients with distal
esophageal cancer varies between different
stent designs. Concurrent treatment with
chemotherapy and/or
radiotherapy seems to be safe and effective. In the future, it can be expected that removable
stents will be used as a bridge to surgery to maintain
luminal patency during
neoadjuvant treatment. For benign
strictures, new
stent designs, such as fully covered SEMS and biodegradable
stents, may potentially reduce complications during
stent removal.