Stents and Emerging Alternatives in Upper Gastrointestinal Endoscopy: A Comprehensive Review.

Endoscopy has revolutionized the management of gastrointestinal (GI) conditions, enabling less invasive treatments for cases that once required surgery. Among these innovations, endoscopically placed stents have played a crucial role in the treatment of upper GI tract diseases for many years. Today, stents remain a valid first-line treatment for specific indications; however, advancements in endoscopic technologies have led to a reassessment of their role in some conditions. While stents are still the primary choice for palliation of malignant esophageal strictures, endoscopic vacuum therapy (EVT) has demonstrated superior outcomes for esophageal leaks, and Endoscopic UltraSonography-guided placement of lumen-apposing metal stents (LAMS) has outperformed traditional stents in gastric obstructions. This review evaluates current stent indications, highlighting upper GI conditions where they remain the best option, while also exploring emerging technologies and updated clinical guidelines to optimize patient care.