Esophageal stenting is an effective palliative treatment for mid- to late-stage esophageal cancer, which can improve patients’ dysphagia, improve their quality of life, prolong survival and gain time for radiotherapy. However, internal stenting has potential dangers and complications, which can be fatal in serious cases, so the treatment of its complications needs high attention. Common complications and treatment 1, chest pain and foreign body sensation: post-stenting pain and discomfort after stenting of varying degrees, without special treatment, can disappear in 1 week after surgery, the more intense application of analgesic drugs to relieve pain …… irritation symptoms and esophageal foreign body sensation will gradually adapt to disappear with the improvement of eating. 2, gastroesophageal reflux: patients should be observed for nausea, acid reflux, heartburn, chest pain, etc. Instruct the patient to establish new eating habits: a small number of meals, keep sitting or upright position after meals, take the lying position after 1-2h of eating, sleep without eating, and raise the head of the bed 15-30° when sleeping. Appropriate gastro-dynamic drugs and acidulants and mucosal protective agents. 3, food embedding: patients should be closely observed eating, such as vomiting, obstruction, etc., or postoperative patients were eating very smoothly, suddenly occurred swallowing obstruction more suggestive of food embedded in the stent, should do gastroscopy, and release the embedding. Bleeding: The normal anatomical and physiological characteristics of esophagus, pathological changes of esophageal cancer, defects of stent itself, radiotherapy after stent placement and inappropriate treatment are the main risk factors for bleeding after esophageal stenting. (1) Treatment of bleeding: closely observe patients’ vital signs and facial color after surgery, such as pallor, blood pressure drop, vomiting blood or black stool, etc. The amount and nature of bleeding should be closely observed. Mostly a small amount of bleeding can stop on its own, mild bleeding can be given orally with norepinephrine, anorectic blood and other drugs. (2) Emergency treatment for hemorrhage: establish intravenous access as soon as possible to replenish blood volume, emergency hemorrhagic shock, while intravenous injection of hemostatic drugs, vasoconstrictors; intraesophageal instillation of ice saline; search for bleeding-related arteries, balloon catheter compression to stop bleeding; anti-arrhythmia, cough and vomiting; after the bleeding is stopped and the condition is stable, remove the stent at once. 5.Esophageal perforation and rupture occur due to transesophageal dilatation of esophagus or dilatation of esophagus with oversized balloon, which can be avoided by proper material selection and operation standard. 6.Stent displacement: It is easy to happen when the stent is inaccurately positioned at the time of stent placement, poor expansion of the stent and during the treatment of the primary lesion. Regular review should be paid attention to after stent placement. For those who have poor stent expansion, it can be avoided by using balloon trachea to expand in the stent. Once the stent is displaced, the stent is promptly reset by endoscopic lifting with biopsy forceps or removed and reinserted. 7. Restenosis: The use of overlapping stents avoids restenosis caused by tumor tissue growth protruding into the stent through the reticular space of the stent. The occurrence of restenosis is mainly caused by the growth of tumor tissue exceeding the upper and lower ports of the stent. Prevention should pay attention to the treatment of the primary lesion after stent placement to avoid further growth of tumor tissue. For treatment, another stent can be placed in the restenotic section, and the crimp between the upper and lower stents is more appropriate at 50px. 8.Cardiac arrhythmia and abscess chest: rare, related to stimulation of vagus nerve and rupture of esophageal mediastinal pleura, respectively. How to reduce complications? 1.Strictly grasp the indications and contraindications. Indications (1) Esophage-tracheal fistula or esophageal mediastinal fistula caused by malignant tumor; stenosis, esophagotracheal fistula and esophageal mediastinal fistula after radiotherapy for esophageal cancer. (2) Ruptured esophageal fistula due to benign lesions, such as trauma, postoperative anastomotic fistula, chemical burn rupture, etc., where conservative treatment has failed or surgical treatment is not tolerated; (3) repeated balloon dilatation for benign esophageal strictures with poor results. Contraindications (1) coagulation disorders that cannot be corrected; (2) severe cardiac and pulmonary failure; (3) severe cachexia; (4) severe esophagogastric fundic varices stenting surgery may cause bleeding. (1) The clinical application of balloon catheter dilation with homemade cannula in endoesophageal stenting is to reduce the angle between the anastomosis and the longitudinal axis of the esophagus by passing the homemade cannula through the stenotic section after balloon dilation, so that the operation of the stenting device is carried out inside the cannula, avoiding possible complications such as esophageal perforation, bleeding and peri-anastomotic tissue edema caused by the operation of the stenting device in the dilated esophagus. (2) After radiotherapy (2) After radiotherapy, radiotherapy can reduce the incidence of restenosis and reflux esophagitis, but complications such as esophagotracheal fistula, perforation, bleeding, and stent displacement increase, so whether to perform radiotherapy after surgery needs to be weighed against the contradiction.