Bernardi Francesca, Dell'Anna Giuseppe, Biamonte Paolo, Barchi Alberto, Fanti Lorella, Malesci Alberto, Fuccio Lorenzo, Sinagra Emanuele, Calabrese Giulio, Facciorusso Antonio, Bruni Angelo, Donatelli Gianfranco, Danese Silvio, Mandarino Francesco Vito
Gastroenterology and Gastrointestinal Endoscopy Division, IRCCS San Raffaele Hospital, Via Olgettina 60, 20132 Milan, Italy.
Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Via Olgettina 56, 20132 Milan, Italy.
Diagnostics (Basel). 2025 Sep 16;15(18):2344. doi: 10.3390/diagnostics15182344.
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.
内镜检查彻底改变了胃肠道疾病的治疗方式，使曾经需要手术治疗的病例能够采用侵入性较小的治疗方法。在这些创新技术中，内镜下放置支架多年来在上消化道疾病的治疗中发挥了关键作用。如今，对于特定适应症，支架仍然是一种有效的一线治疗方法；然而，内镜技术的进步导致人们重新评估了它们在某些情况下的作用。虽然支架仍然是恶性食管狭窄姑息治疗的主要选择，但内镜真空治疗（EVT）在食管漏的治疗中已显示出更好的效果，并且内镜超声引导下放置管腔贴附金属支架（LAMS）在胃梗阻的治疗中比传统支架表现更优。本综述评估了当前支架的适应症，突出了它们仍然是最佳选择的上消化道疾病情况，同时也探讨了新兴技术和更新的临床指南，以优化患者护理。
