Semin intervent Radiol 2001; 18(3): 327-338
DOI: 10.1055/s-2001-17939
Copyright © 2001 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Metal Enteral Stents: An Endoscopist's Perspective

James J. Farrell1 , David L. Carr-Locke2
  • 1Gastrointestinal Unit, Massachusetts General Hospital; Gastroenterology Division, Brigham and Women's Hospital; Department of Medicine, Harvard Medical School
  • 2Gastroenterology Division, Brigham and Women's Hospital; Department of Medicine, Harvard Medical School, Boston, Massachusetts
Further Information

Publication History

Publication Date:
18 October 2001 (online)

ABSTRACT

Self-expanding metal stents are increasingly placed by therapeutic endoscopists to manage advanced upper and lower gastrointestinal malignancy. Endoscopic insertion appears to be as safe and effective as radiologic insertion; additionally, endoscopy allows access to areas not routinely accessible by fluoroscopy (e.g., jejunum and proximal colon) and direct visualization of strictures before and after stent insertion, and it provides management options for dealing with complications of enteral stent insertion. This review concentrates on the endoscopic use of self-expanding metal stents in the management of gastrointestinal strictures, detailing the types of enteral metal stents available and the techniques, results, and complications of insertion.

REFERENCES

  • 1 American Society of Gastrointestinal Endoscopy. Technology assessment status evaluation: stents for gastrointestinal strictures.  Gastrointest Endosc . 1998;  47 588-593
  • 2 Domschke W, Foerster E C, Matek W, Rodl W. Self-expanding mesh stent for esophageal cancer stenosis.  Endoscopy . 1990;  22 134-136
  • 3 Nelson D. The Wallstent I and II for malignant esophageal obstruction.  Gastrointest Endosc Clin N Am . 1999;  9 403-412
  • 4 McIntee B E. The Wallstent endoprosthesis.  Gastrointest Endosc Clin N Am . 1999;  9 373-381
  • 5 Skerven G J, Spain-Stewart B. The Z-stent.  Gastrointest Endosc Clin N Am . 1999;  9 367-372
  • 6 May A, Gossner L, Feess G, Bauer R, Ell C. Extraction of migrated self-expanding esophageal metal stents.  Gastrointest Endosc . 1999;  49 524-526
  • 7 Mokhashi M S, Hawes R H. The Ultraflex stents for malignant esophageal obstruction.  Gastrointest Endosc Clin N Am . 1999;  9 413-422
  • 8 Mayoral W, Fleischer D E. The EsophaCoil stent for malignant esophageal obstruction.  Gastrointest Endosc Clin N Am . 1999;  9 423-430
  • 9 Tytgat G N. Endoscopic therapy of esophageal cancer: possibilities and limitations.  Endoscopy . 1990;  22 263-267
  • 10 Dua K S, Kozarek R, Kim J. Self-expanding metal esophageal stent with anti-reflux mechanism.  Gastrointest Endosc . 2001;  53 603-613
  • 11 Kozarek R A. Complications and lessons learned from 10 years of expandable gastrointestinal prostheses.  Dig Dis . 1999;  17 14-22
  • 12 Raijman I, Siddique I, Ajani J, Lynch P. Palliation of malignant dysphagia and fistulae with coated expandable metal stents: experience with 101 patients.  Gastrointest Endosc . 1998;  48 172-179
  • 13 Schmassmann A, Meyenberger C, Knuchel J. Self-expanding metal stents in malignant esophageal obstruction: a comparison between two stent types.  Am J Gastroenterol . 1997;  92 400-406
  • 14 May A, Hahn E G, Ell C. Self-expanding metal stents for palliation of malignant obstruction in the upper gastrointestinal tract. Comparative assessment of three stent types implemented in 96 implantations.  J Clin Gastroenterol . 1996;  22 261-266
  • 15 Weaver D W, Wiencek R G, Bouwman D L, Walt A J. Gastrojejunostomy: is it helpful for patients with pancreatic cancer?.  Surgery . 1987;  102 608-613
  • 16 de Baere T, Harry G, Ducreux M. Self-expanding metallic stents as palliative treatment of malignant gastroduodenal stenosis.  AJR Am J Roentgenol . 1997;  169 1079-1083
  • 17 Bethge N, Breitkreutz C, Vakil N. Metal stents for the palliation of inoperable upper gastrointestinal stenoses.  Am J Gastroenterol . 1998;  93 643-645
  • 18 Soetikno R M, Lichtenstein D R, Vandervoort J. Palliation of malignant gastric outlet obstruction using an endoscopically placed Wallstent.  Gastrointest Endosc . 1998;  47 267-270
  • 19 Yim H B, Jacobson B C, Saltzman J R. Clinical outcome of the use of enteral stents for palliation of patients with malignant upper GI obstruction.  Gastrointest Endosc . 2001;  53 329-332
  • 20 Deans G T, Krukowski Z H, Irwin S T. Malignant obstruction of the left colon.  Br J Surg . 1994;  81 1270-1276
  • 21 Lo S K. Metallic stenting for colorectal obstruction.  Gastrointest Endosc Clin N Am . 1999;  9 459-477
  • 22 Cole S B, Osman H. Endoluminal stenting for relief of colorectal surgery is safe and effective.  Colorectal Dis . 2000;  2 282-287
  • 23 Sandha G S, Marcon N E. Expandable metal stents for benign esophageal obstruction.  Gastrointest Endosc Clin N Am . 1999;  9 437-446
  • 24 Tamim W Z, Ghellai A, Counihan T C. Experience with endoluminal colonic wall stents for the management of large bowel obstruction for benign and malignant disease.  Arch Surg . 2000;  135 434-438
  • 25 Kinsman K J, DeGregorio B T, Katon R M. Prior radiation and chemotherapy increase the risk of life-threatening complications after insertion of metallic stents for esophagogastric malignancy.  Gastrointest Endosc . 1996;  43 196-203
  • 26 Grund K E, Storek D, Becker H D. Highly flexible self-expanding meshed metal stents for palliation of malignant esophagogastric obstruction.  Endoscopy . 1995;  27 486-494
  • 27 Bethge N VN. Non-fluoroscopic placement of metal stents in malignant esophageal obstruction.  Gastrointest Endosc . 1998;  47 AB26(Abst)
  • 28 Ellul J P, Watkinson A, Khan R J, Adam A, Mason R C. Self-expanding metal stents for the palliation of dysphagia due to inoperable oesophageal carcinoma.  Br J Surg . 1995;  82 1678-1681
  • 29 Winkelbauer F W, Schofl R, Niederle B. Palliative treatment of obstructing esophageal cancer with nitinol stents: value, safety, and long-term results.  AJR Am J Roentgenol . 1996;  166 79-84
  • 30 Baron T M, Yates M R. Use of expandable metal stents for malignant gastrointestinal luminal obstruction.  Clin Perspect Gastroenterol . 1999;  1 16-24
  • 31 Raijman I. Avoidance and management of expandable metallic stent-related complications.  Techniques in Gastrointestinal Endoscopy . 2001;  3 108-119
    >