[Self-expandable metallic stent for unresectable malignant esophageal stricture]

Intraesophageal stenting using a self-expandable metallic stent is currently the first choice for patients with unresectable malignant stricture of the esophagus to improve their quality of life because of its efficacy and less invasiveness. Two types of stent are commercially available in Japan. The Ultraflex stent (Boston Scientific Co. Ltd.) is more flexible and less expandable than the Cook-Z stent (Wilson-Cook Co. Ltd.). Care should be taken based on the position of the stricture. Stenting in the cervical esophagus may cause discomfort. Stenting for a lesion adjacent to the airway may cause airway obstruction. Therefore airway stenting or provision for emergency intratracheal intubation is necessary. A stent with an antireflux mechanism would be effective in preventing gastroesophageal reflux following stenting at the esophagogastric junction. The development and legal approval of a stent with antireflux mechanism are expected. Some reported that anticancer treatment after stenting was effective, and some radiologists cautioned against the risk of radiation after stenting. The safety and efficacy of anticancer treatment after stenting remain to be clarified.