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Abstract
Peptic strictures are the most common cause of benign esophageal strictures, other etiology including caustic stricture, post radiation stricture, esophageal webs and some skin disease.
Balloon dilatation is an effective method for management of these strictures, however in case of caustic stricture the incidence of perforation is high up to 33%, in addition balloon dilatation is difficult in many cases.
Temporary placement of a covered retrievable stent can be used in patient with refractory benign esophageal strictures, and removed 4-8 weak later to avoid long term complication.
Esophageal carcinoma account for 7% of all gastrointestinal malignancies and unfortunately most patients are not candidate for surgical management due to advanced cancer staging at time of diagnosis, in this situation the aim of treatment is to restore esophageal lumen and palliate dysphagia.
Balloon dilatation can be used in management of malignant esophageal stricture yet high recurrence rate is the major pitfall.
Esophageal stent is safe and effective palliative treatment with improvement of dysphagia in 92% of patients with malignant esophageal stricture, in addition it is highly effective in management of associated malignant respiratory-esophageal fistula.
Many stent designs are currently available with each design is preferred in specific situation e.g. stent with anti-reflux valve is preferred in malignant lower esophageal stricture; ultraflex stent is preferred in upper esophageal stricture due to its great flexibility.