THE USE OF METAL STENTS IN GASTROENTEROLO GY

A variety of metal stents have been increasingly used for malignant es ophageal, biliary and colorectal stenoses. Esophageal self-expandable stents significantly re duce the early morbidity after implantation co mpared to conventional plastic prostheses. However they offer no benef it in the long-term due to various late complications. Biliary stents offer a significantly longer patency than plastic devices. This advant age is however clinically relevant only for patients with a survival t ime of more than three months. Preliminary trials indicate promising r esults for palliation of colorectal stenoses with metal stents in sele cted cases. Due to a lack of comparative studies the different types o f metal stents must be selected on basis of their physical characteris tics and clinical experiences. Most of the prostheses are irremovable which is a limitation for use in benign stenoses of the gastrointestin al and biliary tract. In addition metal stents are extremely expensive so that carefully designed trials are warrented for evaluation of the cost-benefit ratio.