Patients commonly require an oesophageal stent to be inserted through an endoscopy in order to treat oesophageal cancer
Oesophageal cancer is a malignant growth that starts in the wall of the oesophagus (gullet), which tends to block the passage of food and cause difficulty in swallowing or the feeling of food sticking. Oesophageal cancer can affect the upper, middle or lower oesophagus. Symptoms include pain or discomfort behind your breastbone or in your back. About 7,500 people develop oesophageal cancer every year in the UK.
Your doctor may have recommended this procedure because an operation to remove the cancer is not possible or you may have decided against surgery. Placing a stent in your oesophagus should help you to swallow more easily.
What is a Stent?
A stent is a tube made of a flexible metal mesh. It is passed by mouth into the oesophagus (gullet) and positioned across the area that has narrowed. This is done with the aid of a Gastroscopy, it gently expands to allow fluid and foods to pass through to the stomach more easily.
Your stomach needs to be empty, so do not have anything to eat or drink for at least six hours before the stent insertion.
The procedure will take approximately 20 minutes but can occasionally be longer. You will be given sedation and a flexible tube (endoscope) is then passed down into your oesophagus to the area of narrowing. A wire is passed across the narrowing and the endoscope removed. The stent is then passed over the wire and through the narrowing and then deployed. The endoscope is often passed down a second time to ensure that the stent is placed in the correct place. Occasionally the procedure is done with X-ray guidance to ensure correct positioning. Once deployed, the stent slowly expands over 24-48 hours.
There can be chest or back pain or discomfort afterwards as the stent beds in, but this usually settles after a day or two.
Stent insertion is generally a safe procedure, but as with all medical treatments there are some risks:
Minor bleeding can occur during the procedure. This generally stops without further treatment.
Some people get heartburn and acid reflux afterwards. This can be controlled with simple measures or medicine if necessary.
Occasionally it may not be possible to fit or place a stent for technical reasons. If this is the case, your consultant will discuss this with you.
Very rarely, inserting the stent may cause a tear in the oesophagus. This is a serious complication and may require an operation or another stent insertion.
The stent can move, or ‘migrate’ at a later date. This may require a further stent to be placed.
Despite these possible complications, the procedure is generally very safe and will result in an improvement in your symptoms. After a few days you should not be aware of the stent being in place.
Following your stent insertion, we will keep you in our recovery room and monitor your progress. We do not recommend any food for the first 24 hours whilst the stent continues to expand.
You should be able to go home the same day or day after the operation. However, your doctor may recommend that you stay a little longer. Remember, you won’t be able to drive after the procedure.
You should be able to eat much more easily than before. The stent should help you to swallow more easily, but does not treat the cancer itself. If your swallowing gets worse again, this is probably due to the stent being blocked with food and can be easily treated.
For further information, speak to your consultant or a member of the endoscopy team.