Endoscopic stenting of esophageal perforations

Abstract

The high mortality rates of surgical interventions for esophageal perforation have prompted specialists around the world to search for less traumatic and at the same time effective methods of treatment. A very low incidence of esophageal perforation that leads to severe complications does not provide an opportunity to acquire a large clinical experience. Esophageal stent implantation is one of the technologies of choice with low mortality rates with timely treatment. There are many factors including stent characteristics that influence the clinical success of stenting in esophageal perforation. Stenting for esophageal perforation has not been introduced into widespread practice due to the high frequency of stent migration that significantly worsens the prognosis due to progressive mediastinal infection. This complication is due to the absence of stenosis in the unchanged wall of the esophagus. How-ever, at present, with the development of progress and technological improvement of the designs of modern stents the migration rates in world practice are significantly reduced. The purpose of this review is to highlight both the technology itself and the problems of stenting in esophageal perforations and methods of their prevention.