Stenting

A stent is an implantable device that is used in the body to keep a tubular organ (such as a blood vessel in the heart, or in this case, the esophagus) open. Most commonly, in the esophagus, stents are used to treat the symptoms of advanced esophageal cancer. One of the important symptoms of esophageal cancer is difficulty swallowing food as a result of compromise of the esophageal lumen from the tumor growing. In patients that are not candidates for surgery, esophageal stents are often used to open the esophageal lumen and allow for return of swallowing function. The  metal mesh stent is placed under endoscopic and x-ray guidance and can help significantly improve symptoms. The stent doesn’t shrink or eliminate the tumor – it just pushes it out of the way to allow food to pass. Although many patients are able to resume a normal or near normal diet after an esophageal stent, some patients may need to still restrict their diet to liquids or soft food (your doctor will guide you). Not uncommonly, there may be chest pain or pressure after stent placement as the metal mesh expands to push the tumor away. In most patients this pain subsides over a few days, but in some patients it may be severe enough to remove the stent (which can be done endoscopically). An important consideration when placing an esophageal stent is the location of the tumor. In esophageal tumors located at or near the gastro-esophageal junction, the stent may cross into the stomach. It will then allow food to pass the tumor and fall into the stomach, but as a side effect may cause reflux of gastric contents into the esophagus. This may cause heartburn or even aspiration pneumonia if precautions are not taken. These precautions include antacids, eating only when upright, and avoiding laying down for a few hours after a meal.