Complications of endoscopic esophageal stent implantation

Abstract

Endoscopic esophageal stent implantation is an effective method for dysphagia management in malignant esophageal stricture. However, this technology is associated with the risk of many complications, including those fatal to life. These include bleeding, restenosis, stent fragmentation and destruction, stent migration, pneumomediastinum, the formation of esophageal fistulas, perforations, clogging of the stent with food, retrosternal pain, gastroesophageal reflux changes, airway compression, aspiration pneumonia, and fever. The overall complication rate is 3640%. Mortality rates associated with stenting is between 3.9 and 27.2%. Nevertheless, today there are ways to minimize the incidence of complications due to the constant progress of endoscopic technologies and improvements in the design of modern stents. In addition, most endoscopic interventions can manage the vast majority of complications effectively after stent implantation subject to their early detection. Optimal selection of an esophageal stent and careful selection of patients with a low risk of complications associated with stent implantation are important problems in the prevention of complications to achieve high efficiency of stenting. Evaluation of risk factors for possible complications, the design of stents and their characteristics, as well as using modern methods of effective management of possible complications improves the quality and duration of life in incurable patients with esophageal cancer. The review reflects all possible complications of stenting in esophageal and gastroesophageal junction, factors affecting the occurrence of complications, as well as modern and effective methods of their correction and prevention.