Stent for nonmalignant leaks, perforations, and ruptures

Esophageal nonmalignant leaks, perforations, and ruptures can be considered a diagnostic and therapeutic challenge, even for expert endoscopists. Early recognition and diagnosis are mandatory to reduce the morbidity and mortality and to define the best therapeutic approach. Traditionally, surgical repair of the perforation and leaks or esophagectomy (mortality up to 30%) has been the gold standard of treatment. In view of the high morbidity and mortality of surgical options, more conservative, endoscopy-based approaches have been developed in the past 20 years with encouraging results, making endoscopy a valid and effective alternative to surgery in most patients with an esophageal wall defect. We present an overview of the management of these conditions using metal and nonmetal self-expandable stents. Technical suggestions and clinical issues are discussed in detail and analyzed with regard to outcome and follow-up.