Metallstents in der Gastroenterologie

Abstract

Self-expanding metal stents have, when introduced in their constrained form through gastrointestinal and biliary strictures, a relatively small diameter. Once placed through the stricture and released, however, they expand to a much larger internal diameter, thus giving rise to sufficient palliative reopening of these strictures. Since metal stents are usually not removable, their primary use has been in malignant stenoses. Benign strictures should be treated with metal stents only in exceptional situations. For palliation of dysphagia in esophagocardial malignancies, metal stents have been shown to be associated with significantly fewer initial complications on placement than plastic tubes. The long-term fate of both stent types seems to be similar. In the palliation of malignant jaundice, metal stents were demonstrated to have a significantly longer patency rate, resulting in a favourable cost-benefit ratio despite the high price of metal stents. Continued developments are necessary to further reduce long-term complications and effectiveness.

Douze années de pose d’endoprothèses rectocoliques: résultats et suivi chez 204 patients

“…Pour une sténose colique bénigne, la mise en place d'une endoprothèse apparaît plus controversée dans les petites séries rapportées à ce jour, par rapport à la pathologie maligne [9,20]. Ainsi, une diverticulite aiguë est une contre-indication formelle aux prothèses sauf en pré-opératoire immédiat [21][22][23].…”

“…In the limited series reported to date, stent placement appears less effective and more controversial for benign stenosis than for malignant obstructions [9,20]. Acute inflammation in the colonic segment where a stent should be inserted, as may occur with diverticular disease, is a formal contraindication, except prior to surgery [21][22][23].…”

Y-Nitinol Airway Stent for Management of Central Airway Compression Due to Metastatic Colon Cancer

“…Esophageal stent insertion is an established procedure in patients with dysphagia due to a mediastinal tumor mass [9]. Especially where stents are placed in the proximal esophagus for intrinsic or extrinsic compression, tracheobronchial dislodgement of tumor mass by the stent can cause the complication of airway compression.…”

Minimalinvasives Management einer ausgedehnten mediastinalen Anastomoseninsuffizienz nach Ösophagusresektion mit einem gecoverten selbstexpandierbaren Metallstent

“…Verlässliche Zahlen zur Häufigkeit solcher Ereignisse liegen aber bislang nur aus Studien vor, bei denen SEMS bei malignen ösophagokardialen Stenosen implantiert wurden [8, 14 -16]. Ein weiterer grundsätzlicher Nachteil selbstexpandierbarer Metallstents ist, dass sie sich nicht oder nur äußerst schwierig wieder entfernen lassen [16]. Dabei ist aber die Entfernung des Metallimplantates bei einer ausgeheilten "benignen" Anastomose in der Regel wünschenswert.…”