EXPANDABLE METALLIC ESOPHAGEAL STENTS IN BENIGN DISEASE - A CAUSE FORCONCERN

Over a 2-year period at our institution, 6 patients underwent metallic stent treatment, 5 for malignant conditions and 1 for a benign condit ion of the esophagus. The use of expandable metallic stents for benign strictures has paralleled malignant indications but is limited and le ss understood from a clinical standpoint. A review of current literatu re in the treatment of benign strictures is presented. Treatment of be nign strictures is associated with high morbidity and mortality as dem onstrated by the cumulative experience of 21 patients. Migration, hype rplastic tissue obstruction at the terminal ends, reflux, and complica tions of perforation occur at a prohibitive rate. We conclude that exp andable metallic stents should be reserved for palliative treatment of esophageal malignant obstructions and tracheoesophageal fistulas. Pha rmacological management: necessary dilatations and operative correctio ns (antireflux procedures, esophagectomy) are recommended treatments f or benign strictures.