Use of stents in benign and malignant esophageal disease

The currently available endoscopic treatment modalities for the palliation of malignant dysphagia outside of self-expandable stent placement are, as yet, not optimal for achieving rapid and sustained dysphagia relief with minimal morbidity and mortality. Self-expanding stents are effective in improving dysphagia; however, the number of re-interventions needed for management of recurrent dysphagia remains higher than initially anticipated. The introduction of newer-generation stents may reduce stent migration and nontumoral tissue overgrowth and result in a decrease in the need for re-intervention. The use of self-expandable stents for benign esophageal disease has shown promising results for the treatment of anastomotic leaks and perforations. However, the data on benign esophageal strictures have been mixed. Multicenter, prospective studies are needed to evaluate the late complication rate and long-term effectiveness in this difficult-to-treat patient population with refractory esophageal strictures. Future developments in stent design include biodegradable stents, stents with a radioactive coating, and drug-eluting stents.