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Oesophageal Stent Insertion

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Oesophageal Stent Insertion

What is a Stent?

A stent is a tube made of a flexible metal mesh. It is passed by mouth into the oesophagus (gullet) and positioned across the area that has narrowed. This is done with the aid of a Gastroscopy (please read accompanying information sheet). It gently expands to allow fluid and foods to pass through to the stomach more easily.

What does a stent look like?

How do I prepare for my stent insertion?

If you are not already an in-patient you will be admitted to the Endoscopy Unit on the day of the procedure. Your stomach needs to be empty, so do not have anything to eat or drink for at least six hours before the stent insertion.

Your preparation will be the same as that of a patient undergoing a Gastroscopy so please ensure you read the information sheet carefully.

A Stent insertion will always be carried out under sedation.

Ref: PIID 365 Date: May 2015 Review: May 2017

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How long will it take?

The procedure will take approximately 20 minutes but can occasionally be longer.

How is the stent inserted?

You will be given sedation and a flexible tube (endoscope) is then passed down into your oesophagus to the area of narrowing. A wire is passed across the narrowing and the endoscope removed. The stent is then passed over the wire and through the narrowing and then deployed. The endoscope is often passed down a second time to ensure that the stent is placed in the correct place. Occasionally the procedure is done with X-ray guidance to ensure correct positioning. Once deployed, the stent slowly expands over 24-48 hours.

Will it hurt?

There can be chest or back pain or discomfort afterwards as the stent beds in, but this usually settles after a day or two. There are several ways of treating this and your doctor will discuss this with you before the procedure.

What are the risks and benefits?

Stent insertion is generally a safe procedure, but as with all medical treatments there are some risks:

 Minor bleeding can occur during the procedure. This generally stops without further treatment.

 Some people get heartburn and acid reflux afterwards. This can be controlled with simple measures or medicine if necessary.

 Occasionally it may not be possible to fit or place a stent for technical reasons. If this is the case, your consultant will discuss this with you.

 Very rarely, inserting the stent may cause a tear in the oesophagus. This is a serious complication and may require an operation or another stent insertion.  The stent can move, or 'migrate' at a later date. This may require a further stent to

be placed.

 Despite these possible complications, the procedure is generally very safe and will result in an improvement in your symptoms.

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When will I be able to eat and drink?

Following your stent insertion, we will keep you in our recovery room and monitor your progress. Generally you will be offered a drink of water after 1-2 hours. If this is well tolerated you may have a tea or coffee.

We do not recommend any food for the first 24 hours whilst the stent continues to expand. Following this there is a list below that you are advised to follow.

What kind of food can I eat?

Foods to AVOID Suitable Alternatives Fish

Tough fibrous meats Tender meat/poultry cut across the grain Fresh/doughy crispy bread Toast

Hard foods such as nuts, crisps, crackers, hard chips

Hard boiled eggs Scrambled, poached, omelette, egg mayonnaise

Fruit with pith, pips and stringy texture e.g. Rhubarb, strawberries, raspberries, kiwis

Fruit juices, bananas, melon (remove pips)skinless grapefruit/orange segments, stewed apple (no skins/pips)seedless & skinless grapes, peaches & nectarines (no skin/pips)

Vegetables with pips and stringy textures e.g. Celery, green beans, sweetcorn, peas, broccoli & cauliflower stalks

Vegetables without pips and stringy textures e.g. Carrot, parsnip, broccoli, cauliflower , courgette. Mushy peas

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When will I be able to go home?

It may be necessary for you to stay in hospital for 1-2 nights and we therefore advise you to bring an overnight bag. Some patients will be allowed to go home after

approximately 4 hours. Following the procedure and during your recovery phase we will be able to advise you further.

Looking after your stent:

 Sit upright when you eat and try to relax.  Take small mouthfuls of food.

 Eat slowly and chew your food well.

 Use plenty of sauces, gravy and butter to moisten food.

 If your appetite is poor, try to have small and frequent nourishing meals.  Try to have warm drinks whilst eating to prevent the tube from blocking.  Have nourishing drinks between meals.

What if the stent becomes blocked?

Stent blockage usually causes pain or difficulty on swallowing or regurgitation of food. Try not to panic if you feel that your stent is blocked. The following actions may help: -  Stop eating.

 Try standing up and walking around the room.  Take small sips of a fizzy drink.

 If the blockage persists contact the Upper GI Nurse Iain Mackay or your Consultants secretary.

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Can the stent come out?

Once the stent is in place it will usually be permanent. In unusual circumstances the stent may slip out of position, but it is unlikely that we would attempt to remove the stent unless absolutely necessary.

If you have any further questions please contact

 Upper Gastrointestinal Specialist Nurse Iain Mackay on 01895 279298  The Endoscopy Unit on 01895 279214

Useful national groups

Oesophageal Patients’ Association Tel: 0121 704 9860 www.opa.org.uk

Email: [email protected] Cancer BACUP

www.cancerbacup.org.uk

(National cancer information and support service) Tel: 020 7613 2121 or 0808 800 1234

This information is intended as a guide, if you have any

questions, however small they may seem, please ask, we are

here to help.

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Please ask if you require this information in other languages, large print or audio format. Please contact: 01895 279973

Fadlan waydii haddii aad warbixintan ku rabto luqad ama hab kale. Fadlan la xidhiidh 01895 279 973

Jeżeli chcialbyś uzyskać te informacje w innym języku, w dużej czcionce lub w formacie audio, poproś pracownika oddzialu o kontakt z biurem informacji pacjenta (patient information) pod numerem telefonu: 01895 279973.

如果你需要這些資料的其他語言版本、大字体、或音頻格式,請致電01895 279 973 查詢。

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