Endoscopic esophageal stent placement

Endoscopic esophageal stent placement

How many people can resist the temptation of delicious food? However, some patients with esophageal diseases find delicious food "out of reach" due to difficulty in swallowing.

Esophageal stent implantation helps solve the problem of difficulty in eating, allowing patients with esophageal diseases to enjoy delicious food just like healthy people. Now let's take a brief look together!

1️⃣. What is esophageal stent placement?

By placing a stent in the esophagus and using mechanical force to push open the narrow part of the esophagus, it can be restored to patency, allowing food to be swallowed smoothly. It can immediately relieve dysphagia, improve the nutritional status of patients, and has the advantages of small trauma, high therapeutic effect, low risk, few complications and short hospital stay.

2️⃣. Who is suitable for esophageal stent implantation?

① Patients with advanced esophageal cancer or cardia cancer stenosis who are not suitable for surgical treatment;

② Esophageal stenosis caused by chemical injury or other traumas;

③ Scarring esophageal stenosis and stenosis after radiotherapy;

④ Anastomotic stenosis after esophageal cancer surgery;

⑤ Postoperative recurrence of esophageal cancer;

⑥ Esophagotracheal fistula, esophagomediastinal fistula;

⑦ For traumatic esophageal fistula that cannot be immediately repaired by surgery, it is used as a transitional treatment.

⑧ External pressure stenosis of the esophagus;

⑨ Achalasia of the cardia, etc.

3️⃣What should be noted after the operation?

① Condition observation: Closely monitor vital signs after the operation, especially blood pressure and heart rate, to prevent heart and lung diseases induced by the stimulation of esophageal stents.

② Psychological care: Inform the patient that an adaptation period is needed after the stent is placed.

③ Pay attention to rest: Avoid large changes in body position to prevent the stent from shifting.

④ Prevent reflux: If the stent is placed across the cardia, an appropriate amount of acid suppressant should be given. Instruct the patient not to lie flat after meals and to raise the pillow or place them in a semi-reclining position when sleeping to prevent food reflux.

4️⃣When can I have a meal after the operation?

① The stent can only be safely opened 20 hours after implantation. To prevent displacement, a 24-hour fasting period is required after the operation.

② Within a week, consume liquid food. After that, gradually transition to semi-liquid and soft food. Eat small meals frequently and chew slowly.

③ Do not consume dry, hard, large or coarse-fiber foods to avoid clogging the support. If it occurs, foreign body removal under gastroscopy can be performed.

④ Avoid hot, cold and acidic foods to prevent the esophageal stent from expanding and contracting due to temperature changes or being corroded, which may cause the stent to deform, shift or fall off. If it occurs, you can try adjusting the position of the stent under gastroscopy. If it cannot be adjusted, remove it or reposition it.

⑤ Drink a small amount of warm water before and after eating to flush the esophagus to prevent food from getting stuck and blocked.

5️⃣. What complications are there after the operation?

1.Bleeding: Due to the high expansion tension at both ends of the stent, the esophagus is compressed, causing local ischemia, necrosis and the formation of ulcers. Therefore, it is necessary to pay attention to whether there is hematemesis, melena and other conditions. After they occur, acid-suppressing and hemostatic drugs should be given.

2. Chest pain: The larger the diameter of the stent and the better its patency, the stronger the chest pain will be. Therefore, choosing an appropriate esophageal stent before the operation can alleviate the patient's pain without affecting their eating. Chest pain caused by stent dilation usually disappears within two weeks and does not require special treatment. If chest pain is caused by gastric or esophageal reflux, antacids and gastric motility promoters can be added.

3. Reflux esophagitis: The expansion of the implanted stent causes the loss of function of the cardia. After placement, it leads to reflux symptoms, resulting in severe reflux esophagitis and aspiration pneumonia. Acid reflux not only causes pain but also promotes inflammatory granulation hyperplasia, leading to restenosis. When eating, try to sit or raise the head of the bed. Wait for 1 to 2 hours after eating before lying down to relieve reflux symptoms.

4. Stent displacement and detachment: Manifested as recurrence of dysphagia. The reasons include inaccurate positioning, being too high or too low; Excessive dilation and detachment into the stomach at the narrow site; The stenotic segment is too short, and the stenotic part is compressed and necrotic by the stent, resulting in the enlargement of the esophageal lumen. Choosing the appropriate stent and having a correct diet after the operation can help reduce stent displacement. In the event of this complication, the position can be adjusted or repositioned.

5. Restenosis: Common causes of restenosis include tumor recurrence or granulation tissue hyperplasia, which mostly occur 1 to 2 weeks after surgery. The symptoms of those with tumors or granulation tissue hyperplasia can improve after electrocoagulation therapy.

The emergence of esophageal stent implantation has brought unprecedented therapeutic hope to patients with esophageal diseases. It is not merely a breakthrough in medical technology, but also a profound concern for the quality of life. Let's join hands and use the power of technology to dispel the shadow of diseases, enabling every patient to regain a healthy body and a bright smile, and bravely move towards a brighter future. In this world full of love, let's look forward to the blooming and rebirth of every life together!