Endoscopic treatment of stenoses and leaks in the gastrointestinal tract: The role of self-expandable metal stents

To determine the role of stent placement for benign esophageal strictures (BES), we studied which strictures poorly respond to standard dilation therapy and whether increasing the target diameter of bougie dilation can further optimize the outcomes of dilation therapy. Hereafter, the clinical outcomes of esophageal stent placement for benign strictures and anastomotic leaks, perforations and fistulas have been analyzed. We found that the clinical success rates of stent placement for benign esophageal leaks, perforations and fistulas widely varied. Therefore a clinical prediction rule was developed to predict the individual probability of successful stent therapy. In addition to the analyses of the outcomes of stent placement, we also addressed the safety of endoscopic stent removal from the esophagus after temporary stent placement. A small subgroup of patients with therapy-resistant benign esophageal strictures (TRBES) does not respond to endoscopic treatment. In this subgroup of patients we studied the clinical outcomes of esophageal self-dilation.