Stents and Emerging Alternatives in Upper Gastrointestinal Endoscopy: A Comprehensive Review

Area of Science:

• Gastroenterology
• Minimally Invasive Surgery
• Endoscopic Therapeutics

Background:

• Endoscopic stents have been a cornerstone in managing upper gastrointestinal (GI) diseases, offering less invasive alternatives to surgery.
• Advancements in endoscopic technology necessitate a re-evaluation of traditional stent roles in certain GI conditions.
• Stents remain a primary treatment for malignant esophageal strictures, but newer methods show promise for other indications.

Purpose of the Study:

• To review current indications for endoscopic stents in upper GI conditions.
• To highlight areas where stents remain the optimal treatment.
• To explore emerging endoscopic technologies and updated guidelines for improved patient management.

Main Methods:

• Literature review of current endoscopic stent applications.
• Comparative analysis of traditional stents versus newer endoscopic therapies (EVT, LAMS).
• Evaluation of updated clinical guidelines and technological advancements.

Main Results:

• Endoscopic stents are the first-line treatment for palliation of malignant esophageal strictures.
• Endoscopic vacuum therapy (EVT) shows superior outcomes for esophageal leaks compared to traditional methods.
• Endoscopic UltraSonography-guided placement of lumen-apposing metal stents (LAMS) outperforms traditional stents in gastric obstructions.

Conclusions:

• While endoscopic stents remain crucial for specific upper GI conditions, emerging technologies are redefining treatment paradigms.
• EVT and LAMS represent significant advancements, offering improved outcomes in esophageal leaks and gastric obstructions, respectively.
• A comprehensive understanding of current indications and emerging technologies is essential for optimizing patient care in upper GI endoscopy.