Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Gastrointest Endosc. Mar 16, 2026; 18(3): 116060
Published online Mar 16, 2026. doi: 10.4253/wjge.v18.i3.116060
Published online Mar 16, 2026. doi: 10.4253/wjge.v18.i3.116060
Navigating self-expandable metallic stent placement in inoperable esophageal malignancies: A landmark-based technique using the vertebral column and diaphragm
Mehreen Siyal, Muhammad Asim, Sajida Qureshi, Shahriyar Ghazanfar, Arif R Siddiqui, Naseer Ahmed, Abeer Altaf, Noval Zakaria, Asma Yaseen, Fahad Kakar, Shanil Kadir, Saad Khalid Niaz, Department of Gastroenterology, Sindh Institute of Advanced Endoscopy and Gastroen
Muhammad Khalid Hasan, Center for Interventional Endoscopy, AdventHealth, Orlando, FL 32804, United States
Author contributions: Niaz SK pioneered this novel technique for self-expandable metallic stent placement and imparted this technique to many endoscopists; Niaz SK and Siyal M contributed to the data collection, data analysis, manuscript writing, manuscript editing and provided final approval of the manuscript; Asim M contributed to study conception and design; Qureshi S, Ghazanfar S, Siddiqui AR, Ahmed N, Altaf A, Zakaria N, Yaseen A, Kakar F, Kadir S, and Hasan MK contributed to critical editing of the manuscript for important intellectual content. All authors approved the final submitted version and agreed to be accountable for all aspects of the work, including accuracy and integrity.
Institutional review board statement: This study was approved by the Ethics Committee of the Sindh Institute of Advanced Endoscopy and Gastroenterology (No. ERC/SIAG/Approval/2025/02).
Informed consent statement: This study was conducted retrospectively using data obtained from medical records. As no direct patient contact occurred and all data were anonymized, the requirement for individual informed consent was waived by the Institutional Review Board. An exemption letter was obtained from the institutional ethics committee, and conducted in accordance with the ethical standards of the Declaration of Helsinki. All radiographic images included in this retrospective study were fully anonymised and contain no identifiable patient information; therefore, specific consent for publication was not obtained.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The data that support the findings of this study are available from the corresponding author upon reasonable request. Due to patient privacy and institutional regulations, access to the data is limited to de-identified datasets and may require further ethical clearance.
Corresponding author: Saad Khalid Niaz, FCPS, MRCP (UK), FRCP (LON), CCST GASTRO (UK), Professor, Department of Gastroenterology, Sindh Institute of Advanced Endoscopy and Gastroenterology, Dr. Ruth K.M. Pfau Civil Hospital, Baba-e-Urdu Road, Karachi 75000, Sindh, Pakistan. saadniaz@yahoo.co.uk
Received: November 3, 2025
Revised: November 23, 2025
Accepted: January 15, 2026
Published online: March 16, 2026
Processing time: 132 Days and 8.9 Hours
Revised: November 23, 2025
Accepted: January 15, 2026
Published online: March 16, 2026
Processing time: 132 Days and 8.9 Hours
Core Tip
Core Tip: A novel, landmark-based technique for self-expandable metallic stent placement in patients with inoperable esophageal cancer was investigated in this study. By utilizing the vertebral column and diaphragm as anatomical guides, the procedure became more streamlined, cost-effective, and reproducible without compromising safety or technical success. We achieved a 100% success rate and minimal complications in 801 patients, indicating that this approach offers a practical al