Stent Insertion in the Esophagus
What are Esophageal Stents?
These are instruments used to temporarily or permanently widen esophageal stenosis. They can be silicone and metal. When it is desired to be installed permanently, uncoated ones are preferred. If you want to remove it after a certain period of time, plastic-coated metal stents are more suitable. Since uncovered metal stents adhere to the tissue, there is no possibility of slippage, dislocation or subsequent removal. Plastic-coated metal stents can be removed when it is believed that they provide sufficient permanent width.
Although they have not yet found a full application area in routine practice, biologically self-dissolving stents are also available. The aim here is to avoid the need to remove it later.
There are also stents produced to stop the bleeding of varicose veins in the esophagus by applying pressure.
In what cases should a stent be placed in the esophagus?
If the patient cannot swallow as a result of narrowing or obstruction of the esophagus for various reasons or as a result of external pressure, if the main cause cannot be eliminated by surgery, the patient’s swallowing can be restored by installing self-expanding stents.
- Esophageal cancers
- Masses and compressive lymph nodes in the mediastinum
- lung cancers
How to Insert a Stent in the Esophagus?
How far can the narrow segment be reached with endoscopy? A thin guide wire is passed through the narrows to reach the mussel. To ensure that the guide is in the stomach, contrast material is injected proximal to the stenosis by occlusion with a balloon catheter. When it is understood that the contrast material has passed into the stomach and shows the stomach pacemakers, it is determined that the guide is in the right place. During the same imaging, one should also have an idea about the length of the narrow segment and calculate the length of the stent to be inserted accordingly. The length of the stent should neither be longer nor shorter than the length of the narrow segment. A stent is opened to cover a segment of approximately 2 centimeters proximal and distal to the stenosis.
If the guide wire is not strong enough to move the esophageal stent by sliding the record, it is replaced with another strong guide wire through a thin plastic catheter. later The esophageal stent is passed through the stenosis in a closed state over the Guide Wire and is opened while clearly visible under the microscope. The guide wire and stent carrier are removed after the stent is deployed. You will be able to find videos of cases where we installed esophageal stents here and on our YouTube channel.
Situations Where a Stent Cannot Be Placed in the Esophagus
In some cases, placing a stent in the esophagus may cause more harm than good.
- In patients whose general condition is too poor to tolerate the procedure,
- In cases where it cannot be technically demonstrated that the guide wire passes through the stenosis and into the stomach,
- In cases where the cause of difficulty in swallowing is diagnosed not only in the esophagus but also in the oropharynx