In an esophageal stent procedure, a tube is placed in your esophagus (throat) to keep open a blocked area. The tube helps you swallow solids and liquids.
Your esophagus is the muscular tube connecting the back of your mouth to your stomach. When you swallow, the muscles of your esophagus contract. They propel food into your stomach.
Many health problems can partly block a portion of your esophagus. That can make it hard to swallow. The medical term for this is dysphagia. You might have pain when you swallow or feel like food is getting stuck in your chest. The food might come back up after you swallow. An esophageal stent can help reopen your blocked esophagus and ease symptoms.
The procedure might take place under general anesthesia or conscious sedation. If it takes place under general anesthesia, you will sleep through the procedure and feel no pain. If it takes place under conscious sedation, you will get medicines to make you relaxed and sleepy. The surgeon may numb the area under surgery so that you won’t feel much pain.
During the procedure, the surgeon places a long, thin tube (catheter) down the back of your mouth and into your esophagus. Next, the surgeon places a folded-up hollow tube (stent) over the catheter in the correct position across the blockage. The stent expands against the walls of your esophagus, giving support. Then the surgeon removes the catheter and leaves the stent in place.
You might need an esophageal stent for a number of health problems. Traditionally, healthcare providers have most often used esophageal stents to treat esophageal cancer. That is still the most common reason. But these stents are also used to treat:
- Cancer of the top part of the stomach
- Narrowing of the esophagus as it's pushed from the outside by a cancer (such as lung cancer) or enlarged lymph nodes
- Narrowing of the esophagus from an ulcer
- Narrowing of the esophagus from radiation treatment
- Abnormal opening between the trachea (wind pipe) and esophagus
- A hole in the esophagus
Any of these health problems can cause dysphagia. Dysphagia is serious because it can lead to aspiration. During aspiration, you inhale food and stomach contents into your lungs. That can lead to complications like pneumonia. Dysphagia also lowers your quality of life. An esophageal stent can help ease these problems.
Even if you have esophageal cancer, you may not need an esophageal stent. In some cases, your healthcare provider may be able to treat your cancer with surgery or chemotherapy instead. If these therapies won’t work for you, an esophageal stent may be another option. In other cases, a gastrostomy tube or jejunostomy tube might make more sense for you. These tubes go straight from your outer abdomen to your stomach or small intestine. Talk with your healthcare provider about all your treatment choices.
Esophageal stent procedures are relatively safe. But they do sometimes cause problems later. These might include:
- Pain in the esophagus
- Bleeding (usually mild)
- New hole in the esophagus (rare)
- Movement of the stent
- Tumor growth into the stent
- Gastroesophageal reflux (GERD or heartburn)
There is also a risk that you will need a repeat procedure because of one of these complications. Your own risks may vary based on the nature of your esophageal problem, your other health problems, and the type of stent used. Talk with your healthcare provider about all your concerns.
Talk with your healthcare provider about what you should do to get ready. You may have to stop eating and drinking the night before your procedure. Follow your healthcare provider’s instructions about what medicines to take or not take beforehand. Don’t stop taking any medicine unless he or she tells you to do so. Plan to have someone available to drive you home afterward.
Tell your healthcare provider about the following:
- Any allergies or past problems with anesthesia
- Any new health problems, like a recent fever
- If you are pregnant or might be pregnant
- All medicines you take including prescriptions and over-the-counter medicines and supplements
Your healthcare provider might order some tests before your procedure. These might include a barium swallow test. It can give more information about the anatomy of your esophagus. Just before the procedure, you may receive an IV. It can deliver medicine to you during the procedure.
Your healthcare provider can let you know what to expect. The details of your procedure may differ somewhat. It will usually take around an hour. In general, you can expect the following:
- If you are having conscious sedation, medicine will be given through an IV to make you feel sleepy and relaxed during the procedure. You may also have a numbing medicine put on the back of your throat. You may not remember the procedure afterward.
- If you are having general anesthesia, medicine will be given through an IV to make you sleep deeply and painlessly.
- During the procedure, your heart rate, blood pressure, and other vital signs will be carefully watched. If needed, you might get extra oxygen. Your healthcare provider may use continuous X-ray images to view the procedure. In other cases, he or she might use a long, thin device with a small camera (endoscope).
- The healthcare provider will slowly put a catheter through your mouth and into your esophagus.
- The provider will move the folded-up esophageal stent over the catheter to the blockage site. The stent is often made of metal or plastic. It will then open up against the wall of the esophagus.
- After the procedure has been completed, the provider will remove the catheter from your esophagus. The stent will stay in place.
Typically, esophageal stent placement is an outpatient procedure. You will stay for a few hours afterward while your vital signs are watched. Make sure someone is there to drive you home. You will need to take it easy for the rest of the day. In other cases, you may need to stay at the hospital overnight.
You may have some discomfort after your procedure. But it usually doesn’t last longer than a day or two. You can have over-the-counter pain medicines if you need them.
Your healthcare provider will give you specific instructions about when you can eat and drink again. He or she may also give you other specific instructions about your recovery. Continue to follow up regularly. Let your healthcare provider know right away about any new problems, like fever or acid (gastroesophageal) reflux. You might need a new procedure because of a complication, such as food blockage of the stent or stent movement.
Before you agree to the test or the procedure make sure you know:
- The name of the test or procedure
- The reason you are having the test or procedure
- What results to expect and what they mean
- The risks and benefits of the test or procedure
- What the possible side effects or complications are
- When and where you are to have the test or procedure
- Who will do the test or procedure and what that person’s qualifications are
- What would happen if you did not have the test or procedure
- Any alternative tests or procedures to think about
- When and how will you get the results
Who to call after the test or procedure if you have questions or problems
- How much will you have to pay for the test or procedure
April 23, 2018
Adler DG. Esophageal stents: placement, complications, tips, and tricks. Video J Encyclopedia GI Endosc. 2013;1(1):66-68., Baron TH. Expandable stents in the treatment of esophageal obstruction. UpToDate. http://www.uptodate.com/contents/expandable-stents-in-the-treatment-of-esophageal-obstruction, Hindry P, Hong J, Lam-Tsai Y, Gres F. A comprehensive review of esophageal stents. Gastroenterol Hepatol. 2012;8(8):526-534., Sharma P, Kozarek R. Practice Parameters Committee of American College of Gastroenterology. Role of esophageal stents in benign and malignant diseases. Am J Gastroenterol. 2010;105(2):258-273.
Lehrer, Jenifer, MD,Hanrahan, John, MD