Advances in risk factors and anti-migration strategies for esophageal stent migration

Chen Hanxi; Zhuang Anjie; Zhuang Zehao

doi:10.16689/j.cnki.cn11-9349/r.2026.04.003

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Electronic Journal of Metabolism and Nutrition of Cancer ›› 2026, Vol. 13 ›› Issue (4) : 471-477. DOI: 10.16689/j.cnki.cn11-9349/r.2026.04.003

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Advances in risk factors and anti-migration strategies for esophageal stent migration

¹Chen Hanxi, ²Zhuang Anjie, ²Zhuang Zehao

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Abstract

Esophageal stent placement is a minimally invasive and effective intervention for the management of benign and malignant esophageal strictures and esophageal fistulas, facilitating the rapid restoration of oral intake. Among the available devices, self-expanding metal stents are the most widely used. However, stent migration remains one of the most common complications, significantly compromising therapeutic efficacy and patient outcomes. Migration may result in recurrent dysphagia, fistula reopening, gastrointestinal obstruction, and even tissue injury. This review summarizes the risk factors associated with esophageal stent migration and recent advances in anti-migration strategies. Current evidence indicates that migration is influenced by multiple factors, including stent structural characteristics, covering type, diameter and length, deployment location, severity of stricture, esophageal motility, and chemoradiotherapy. In particular, fully covered stents, smaller stent diameters, placement across the gastroesophageal junction, and tumor regression following chemoradiotherapy are associated with an increased risk of migration. To reduce migration, various anti-migration stent designs have been developed, including stents with fins, circumferential protuberances, double-layer mesh structures, segmented stents, patient-specific three-dimensional (3D)-printed stents, and bioadhesive coatings. These approaches aim to improve stent stability through enhanced mechanical anchorage, better tissue conformity, or increased interface friction. In addition, fixation techniques such as external traction fixation, endoscopic suturing, over-the-scope clips, and through-the-scope clips have been employed to reduce migration in high-risk patients. Nevertheless, these methods remain limited by procedural complexity, cost, and variable long-term efficacy. Although current anti-migration strategies can reduce the incidence of stent migration to some extent, complete prevention remains challenging. Future developments should integrate advances in materials science, bioengineering, 3D printing, and intelligent manufacturing to develop esophageal stents with improved biocompatibility, individualized adaptability, and long-term stability. Furthermore, high-quality prospective clinical studies are required to validate their safety and efficacy and to optimize the clinical benefits of esophageal stent therapy.

Key words

Esophageal stent / Migration / Risk factors / Anti-migration design / Stent fixation techniques / Endoscopic suturing / Bioadhesive materials / Three-dimensional (3D) printing

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Chen Hanxi, Zhuang Anjie, Zhuang Zehao. Advances in risk factors and anti-migration strategies for esophageal stent migration[J]. Electronic Journal of Metabolism and Nutrition of Cancer. 2026, 13(4): 471-477 https://doi.org/10.16689/j.cnki.cn11-9349/r.2026.04.003

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