Esophageal stenting for benign and malignant disease: European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2021

Main recommendations Malignant disease 1 ESGE recommends placement of partially or fully covered self-expandable metal stents (SEMSs) for palliation malignant dysphagia over laser therapy, photodynamic and esophageal bypass. Strong recommendation, high quality evidence. 2 brachytherapy as a valid alternative, alone in addition to stenting, cancer patients with expected longer life expectancy. 3 SEMS sealing tracheoesophageal bronchoesophageal fistulas. low 4 does not recommend bridge surgery before preoperative chemoradiotherapy because it is associated incidence adverse events. Other options such feeding tube are preferable. Benign 5 against the use SEMSs first-line therapy management benign strictures potential events, availability alternative therapies, their cost. 6 suggests consideration temporary refractory strictures. Weak moderate 7 that be preferred treatment very risk embedment ease removability. 8 stent-in-stent technique remove embedded wall. 9 stent can considered leaks, fistulas, perforations. No specific type recommended, duration stenting should individualized. 10 considering large-diameter variceal bleeding medical, endoscopic, and/or radiological initial massive bleeding.