Inserting an oesophageal stent (endoscopy)

Why do patients require an oesophageal stent?

Patients commonly require an oesophageal stent to be inserted through an endoscopy in order to treat oesophageal cancer

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.

Alternatives

It is possible to stretch (dilate) the oesophagus where the cancer has caused it to narrow. This is a similar procedure to inserting a stent, but only makes it easier for you to swallow for a short time.

Other options include laser treatment or techniques such as alcohol therapy and photo-dynamic therapy to shrink the cancer within the oesophagus. A stent will usually allow you to swallow more easily for longer.

The procedure

You won’t be able to eat or drink anything for six hours before the procedure. You may be offered a sedative or painkiller. They will usually spray your throat with some local anaesthetic and ask you to swallow it. This can taste unpleasant.

The endoscopist will ask you to lie down on your left side in a comfortable position and will place a plastic mouthpiece in your mouth.  Your oxygen levels and heart rate will be monitored.

Inserting an oesophageal stent usually takes less than half an hour. The procedure involves placing a flexible telescope (endoscope) into the back of your throat. The endoscopist may ask you to swallow when the endoscope is in your throat. This will help the endoscope to pass easily into your oesophagus.

The endoscopist will place a guidewire (a thin flexible wire) through the endoscope and through the narrowing. They will remove the endoscope while the guidewire is kept in place and will then place a stent, which has not yet been expanded, over the guidewire.

The endoscopist will often take X-rays to make sure the stent is in the right position.

For more information, and if you have any queries about the procedure, speak to your consultant.

Continue your normal medication unless you are told otherwise.

The following lifestyle changes can help make the procedure a success:

• Giving up smoking
• Eating healthily. If overweight, you have a greater chance of developing complications
• Exercising regularly. Your GP can recommend exercises.

Possible complications

• Placing a stent in the wrong position or the stent moving, which is common
• Making a hole in the oesophagus or stomach, which is common. You may need further treatment
• Bleeding when the stent is inserted, or later if the end of the stent rubs against your stomach wall
• Pain, due to pressure from the stent. This usually eases off after a few days
• Blocking of the stent. If food blocks the stent, this normally clears on its own. Having a fizzy drink sometimes helps to clear a blocked stent. However, an endoscopy may be required
• Acid reflux (flow of acid from the stomach up into the oesophagus), if the lower end of the stent lies in the stomach. This may need treatment with medication.

This is not a definitive list and symptoms will vary with each patient. Please ask your consultant for more information.

Recovery

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.

Paying for your procedure

Inserting an oesophageal stent (endoscopy) costs are covered by most medical insurance policies, but please check with your insurer first. If you are paying for your own treatment the cost of the procedure will be explained and confirmed in writing when you book the procedure. Ask the hospital for a quote beforehand, and ensure that this includes the surgeon’s fee, the anaesthetist’s fee and the hospital charge for your procedure.