What is Insertion of Oesophageal Stents?

Insertion of an oesophageal stent is a procedure to place a small plastic or metal tube into the oesophagus (food pipe) to treat oesophageal narrowing or blockage.

The oesophagus is a tube-shaped muscular organ that acts as a passage for food and liquids from your mouth to the stomach. Many health conditions can partly or completely block a section of your oesophagus, making eating or swallowing difficult (dysphagia). Individuals with this problem experience a feeling of food “stuck” in the throat or chest area, along with pain and discomfort. Insertion of an oesophageal stent helps to overcome this problem by holding open any narrowing or blockage. Food and liquids are then able to pass down the oesophagus through the stent into the stomach, making drinking and eating easier.

Indications for Insertion of Oesophageal Stents

Insertion of oesophageal stents is mostly recommended for oesophageal narrowing caused by malignant tumours involving the oesophagus. Before insertion of an oesophageal stent, other diagnostic tests such as a barium swallow study, an endoscopy, or CT scan will have been performed to confirm the diagnosis of oesophageal narrowing or blockage and its cause.

Oesophageal stent insertion may also be used to treat:

Narrowing of the oesophagus from an ulcer
Narrowing of the oesophagus from radiation treatment
Abnormal opening between the oesophagus and trachea (windpipe)
A hole in the oesophagus
Narrowing of the oesophagus due to enlarged lymph nodes or cancer

Preparation for Insertion of Oesophageal Stents

Pre-procedure preparation for insertion of oesophageal stents may involve the following steps:

Depending on your medical history, social history, and age, you may need to undergo tests such as blood work and imaging to help detect any abnormalities that could compromise the safety of the procedure.
You will be asked if you have allergies to medications, anaesthesia, or latex.
You should inform your doctor of any medications or supplements that you are taking or have any medical conditions such as lung or heart disease.
You may need to refrain from certain medications such as blood thinners or anti-inflammatories for a week or two prior to the procedure.
You should not consume any solids or liquids at least 6 hours prior to the procedure.
Arrange for someone to drive you home after the procedure, as you may feel groggy due to the effects of anaesthesia/sedation medicines.
A written consent will be obtained from you after the procedure has been explained in detail.

Procedure for Insertion of Oesophageal Stents

The procedure is performed either under general anaesthesia, where you will be asleep throughout the procedure, or under conscious sedation, where sedation medicines are given to keep you relaxed and sleepy.
Your surgeon may spray a local anaesthetic to the back of your throat to numb the area so that you do not feel much pain.
A fine tube (catheter) or an endoscope is passed through the mouth, and into the oesophagus and then the stricture (narrowing) is crossed with a guidewire utilising fluoroscopic (live X-ray) guidance or endoscopic vision as guidance.
Once the wire is safely across the stricture, the stent mounted on a delivery system is passed over the wire, and once the stent is in a correct position across the narrowing/blockage, the stent is released and will start to gently expand the stricture.
Once satisfactory correction is confirmed, the catheter or scope is then withdrawn.
The procedure may take about 30 to 45 minutes to complete.

Post-Procedure Care and Recovery

Post-procedure care and instructions after insertion of oesophageal stents may involve the following:

You will be transferred to the recovery area where you will be asleep until the sedation or anaesthesia wears off. Your nurse will monitor your vital signs as you recover.
It is normal for you to feel soreness in the throat due to the tube used, along with pain or discomfort once you gain consciousness.
You will be given pain medicines and anti-nausea medications to relieve your pain and discomfort.
You should be able to take liquids once your anaesthetic effect wears off and you no longer feel numbness in your throat.
You should be able to resume your normal diet the following day, unless your physician instructs otherwise.
You may have to stay in the hospital for a day or two to ensure you can eat and drink comfortably before being discharged home.
A follow-up appointment will be scheduled to monitor your progress.

Risks and Complications

Insertion of oesophageal stents is a relatively safe procedure; however, as with any procedure, some risk and complications may occur, such as:

Infection
Anaesthetic complications
Bleeding
Need for repeat/additional procedures
Throat soreness
Chest pain
Heartburn or acid reflux
Tumour growth into the stent
A hole or tear in the oesophagus

Insertion of Oesophageal Stents