Moutzoukis Miltiadis, Argyriou Konstantinos, Kapsoritakis Andreas, Christodoulou Dimitrios
Department of Gastroenterology, University Hospital of Ioannina, Ioannina GR45333, Greece.
Department of Gastroenterology, Medical School and University Hospital of Larissa, Larissa GR41334, Greece.
World J Gastrointest Endosc. 2023 Apr 16;15(4):195-215. doi: 10.4253/wjge.v15.i4.195.
Endoscopic luminal stenting (ELS) represents a minimally invasive option for the management of malignant obstruction along the gastrointestinal tract. Previous studies have shown that ELS can provide rapid relief of symptoms related to esophageal, gastric, small intestinal, colorectal, biliary, and pancreatic neoplastic strictures without compromising cancer patients' overall safety. As a result, in both palliative and neoadjuvant settings, ELS has largely surpassed radiotherapy and surgery as a first-line treatment modality. Following the abovementioned success, the indications for ELS have gradually expanded. To date, ELS is widely used in clinical practice by well-trained endoscopists in managing a wide variety of diseases and complications, such as relieving non-neoplastic obstructions, sealing iatrogenic and non-iatrogenic perforations, closing fistulae and treating post-sphincterotomy bleeding. The abovementioned development would not have been achieved without corresponding advances and innovations in stent technology. However, the technological landscape changes rapidly, making clinicians' adaptation to new technologies a real challenge. In our mini-review article, by systematically reviewing the relevant literature, we discuss current developments in ELS with regard to stent design, accessories, techniques, and applications, expanding the research basis that was set by previous studies and highlighting areas that need to be further investigated.
内镜腔内支架置入术（ELS）是治疗胃肠道恶性梗阻的一种微创选择。以往研究表明，ELS能迅速缓解与食管、胃、小肠、结肠、胆道和胰腺肿瘤性狭窄相关的症状，且不影响癌症患者的整体安全性。因此，在姑息治疗和新辅助治疗中，ELS已在很大程度上超越放疗和手术，成为一线治疗方式。随着上述成功，ELS的适应证逐渐扩大。目前，训练有素的内镜医师在临床实践中广泛应用ELS来处理各种疾病和并发症，如缓解非肿瘤性梗阻、封闭医源性和非医源性穿孔、闭合瘘管以及治疗括约肌切开术后出血。如果没有支架技术的相应进展和创新，上述发展是无法实现的。然而，技术领域变化迅速，这使得临床医生适应新技术成为一项真正的挑战。在我们的综述文章中，通过系统回顾相关文献，我们讨论了ELS在支架设计、配件、技术和应用方面的当前进展，扩展了以往研究奠定的研究基础，并突出了需要进一步研究的领域。
