Year 2026 / Volume 118 / Number 3
Editorial
Stent insertion for malignant esophageal strictures: endoscopy with fluoroscopy or endoscopy alone

127-130

DOI: 10.17235/reed.2025.11715/2025

Jesús García-Cano, Francisco Domper, María Rodríguez,

Abstract
Dysphagia is a debilitating consequence for patients with esophageal cancer. Recanalization of the obstruction with esophageal stents is one of the palliative measures that can most improve the quality of life in these patients. Among patients with dysphagia due to obstructing esophageal cancer, stent insertion has a high technical and clinical success with rapid relief of dysphagia. Interventional radiologists typically insert esophageal stents under fluoroscopic guidance only, whereas endoscopists insert them exclusively under endoscopic monitoring or by endoscopy and fluoroscopy. In this editorial we discuss the study by Relvas, which compares endoscopic-only insertion with fluoroscopy-guided insertion in obstructive esophageal tumors. The difficulties encountered by endoscopists in using proper radiological facilities is probably the main reason for not employing fluoroscopy in esophageal stenting. Proper placement of a guidewire beyond the esophageal stricture is often the first and most critical step in esophageal stenting. The undeployed stent is then slid over the guidewire. Fluoroscopy offers a high degree of certainty that the guidewire has successfully passed through the stenosis, but it is generally assumed that it is not necessary for esophageal stent placement if the stenosis can be passed through with an endoscope. When fluoroscopy is not available, several endoscopic methods can be used for the insertion of esophageal stents. The study by Relvas confirms that the results of endoscopic and fluoroscopic guided insertion are similar. However, ideally, endoscopists should have their own high-quality radiological facilities, such as those available to interventional cardiologists.
New comment
Comments
No comments for this article
References
1. ASGE Technology Committee; Yang J, Das KK, Copland AP, et al. Enteral stent placement for benign and malignant disease. Gastrointest Endosc 2025; 102:469-487. doi: 10.1016/j.gie.2025.03.637.
2. Saranovic Dj, Djuric-Stefanovic A, Ivanovic A, et al. Fluoroscopically guided insertion of self-expandable metal esophageal stents for palliative treatment of patients with malignant stenosis of esophagus and cardia: comparison of uncovered and covered stent types. Dis Esophagus. 2005;18:230-8. doi: 10.1111/j.1442-2050.2005.00484.x.
3. Austin AS, Khan Z, Cole AT, Freeman JG. Placement of esophageal self-expanding metallic stents without fluoroscopy. Gastrointes Endosc 2001;54: 357-9.
4. Dobrucali A, Caglar E. Palliation of malignant esophageal obstruction and fistulas with self expandable metallic stents. World J Gastroenterol. 2010; 16: 5739-45. doi: 10.3748/wjg.v16.i45.5739.
5. Relvas LM, Gago T, Barros S, et al. Is fluoroscopy necessary for oesophageal SEMS placement? A retrospective cohort study. Rev Esp Enferm Dig 2025. doi: 10.17235/reed.2025.11330/2025..
6. White RE, Mungatana C, Topazian M. Esophageal stent placement without fluoroscopy. Gastrointest Endosc 2001;53:348-51.
7. García-Cano J. Endoscopic insertion of oesophageal stents without fluoroscopic guidance. Scand J Gastroenterol 2005;40:1132-3;. doi:10.1080/00365520510023693.
8. Rathore OI, Coss A, Patchett SE, Mulcahy HE. Direct-vision stenting: the way
forward for malignant oesophageal obstruction. Endoscopy 2006;38(4):382-384.
doi:10.1055/s-2005-921040
9. García-Cano J. Colorectal stenting as first-line treatment in acute colonic obstruction. World J Gastrointest Endosc 2013; 5:495-501. doi: 10.4253/wjge.v5.i10.495.
Related articles

Letter

A case of achalasia associated with early esophageal cancer

DOI: 10.17235/reed.2024.10177/2023

Digestive Diseases Image

A case of esophageal histoplasmosis mimicking carcinoma on endoscopy

DOI: 10.17235/reed.2023.9167/2022

Citation tools
García-Cano J, Domper F, Rodríguez M. Stent insertion for malignant esophageal strictures: endoscopy with fluoroscopy or endoscopy alone . 11715/2025


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 9 visits.
This article has been downloaded 0 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 30/10/2025

Accepted: 07/11/2025

Online First: 18/12/2025

Published: 06/03/2026

Article Online First time: 49 days

Article editing time: 127 days


Share
This article hasn't been rated yet.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2026 y Creative Commons. The Spanish Journal of Gastroenterology