What is Self-Expandable Metallic Stent (SEMS)?
Self-Expandable Metallic Stent (SEMS) is a medical device used to maintain patency in various parts of the gastrointestinal tract. These stents are designed to expand when placed in strictures or blockages, providing relief from obstructive symptoms.
Types of SEMS
- Covered SEMS:
- Complete outer covering prevents tissue ingrowth
- Higher migration risk
- Better for malignant strictures
- Uncovered SEMS:
- No outer covering allows tissue embedding
- Lower migration risk
- Better for benign strictures
Clinical Applications
- Esophageal obstruction
- Gastric outlet obstruction
- Colonic obstruction
- Biliary strictures
- Palliative treatment in malignancy
Placement Procedure
- Endoscopic visualization of obstruction
- Fluoroscopic guidance during placement
- Stent deployment under direct visualization
- Confirmation of proper positioning
Post-Procedure Care
- Monitoring for immediate complications
- Dietary modifications
- Regular follow-up
- Assessment of stent function
Potential Complications
- Stent migration
- Tissue overgrowth
- Bleeding
- Perforation
- Food impaction
Long-term Management
- Regular endoscopic assessment
- Management of complications
- Stent removal or replacement when needed
- Ongoing cancer surveillance in malignant cases