Esophageal stenting

  Esophageal cancer is a common malignant tumor with the 6th highest incidence rate. Dysphagia is a common clinical symptom, and if progressive dysphagia occurs, 60%-70% of patients have no surgical indication. For patients without surgical indications, radical radiotherapy combined with chemotherapy is still an effective treatment. However, there are still some patients who cannot tolerate radiotherapy or refuse radiotherapy due to various reasons.  For these patients, active palliative treatment measures to relieve the symptoms of esophageal obstruction and eliminate the nutritional intake obstacle caused by dysphagia are the most important treatment measures. Among many palliative treatment methods for tumor dysphagia, esophageal stent placement is the most commonly used, which is suitable for those who are in poor general condition, cannot tolerate radiotherapy and those who fail radiotherapy or have distant metastasis of tumor.  Esophageal stenting not only solves the serious intake obstruction caused by esophageal obstruction, but also improves the quality of life of patients, greatly improves the nutritional needs of patients, and improves the quality of survival, all patients are able to eat, gain weight significantly, and prolong their lives. Esophageal stent placement is not only suitable for esophageal strictures caused by esophageal tumors, but also has very significant therapeutic effects on esophageal strictures caused by various benign diseases. The indications for esophageal stent placement are introduced as follows 1. advanced esophageal cancer and cardia cancer strictures that cannot be treated surgically; 2. esophageal strictures caused by chemical injuries or other traumas; 3. scarred esophageal strictures and post-radiotherapy strictures; 4. Esophageal cancer postoperative anastomotic stricture; 5. Postoperative recurrence of esophageal cancer; 6. Esophageal tracheal fistula, esophageal mediastinal fistula; 7. Traumatic esophageal fistula that cannot be immediately repaired surgically as a transitional treatment; 8. External pressure esophageal stricture; 9. Delayed cardia, etc.  We can choose to use imported or domestic stents, including nickel-titanium alloy shape-memory stents and stainless steel memory alloy stents with membrane, anti-reflux stents with membrane, etc., according to the economic condition of patients. The whole process of stent release is monitored under the endoscope, and the stent can be placed more accurately because the scope of the lesion can be judged more clearly by operating under direct endoscopic vision.  During the operation, both the operator and the patient are not exposed to X-rays, and the radiation hazard of X-rays can be avoided. After 6 hours, the patient started to eat a warm liquid diet. On the second day, the symptoms of chest pain, nausea and foreign body sensation basically disappeared. The patient’s dysphagia symptoms can be significantly improved 3 days after surgery. Compared with other treatment methods, esophageal stenting has the advantages of relatively easy, safe, low cost, shortened hospital stay, and reduced burden on family members and nursing care.