The placement of self-expanding metal prostheses (PMA) by means of upper digestive endoscopy is used for the palliative treatment of non-resectable malignant esophageal-gastro-duodenal obstructions and in non-operable patients due to their basic characteristics (advanced esophageal carcinoma with distant metastasis, tracheal fistula -esophageal, in those patients not candidates for treatment with surgery and / or chemotherapy-radiotherapy) or benign (benign refractory esophageal strictures, fistulas or perforations), in which case the treatment is decisive.
Many of these patients are in advanced stages of the disease, where due to a large tumor extension or deterioration associated with the neoplastic process, these are not candidates for surgical resection, being the use of PMA of the upper digestive tract, a great alternative for them. The PMA consists of a cylindrical metal mesh that exerts its self-expanding force until it reaches its maximum diameter. PMAs are usually compressed and constricted in a device, being comfortable and easy to release.
The Endoscopy nurse participates in performing the technique, as well as in monitoring the patient, before, during and after. The placement of these prostheses has been increasing due to the advances made in their design, as this is considered a minimally invasive treatment that helps to alleviate the symptoms caused by the difficulty or impossibility of gastric emptying (vomiting, abdominal distension ...) and complications derivatives (decreased intake, dehydration and malnutrition), as well as difficulty in feeding by mouth that can cause esophageal stricture. Patients who undergo this procedure have a rapid improvement after placement.