Endoprosthesis for esophageal stricture and obstruction

  A farmer, aged 76, who was usually fit and healthy and seldom got even a cold, developed a choking sensation after eating 3 months ago, which slowly became difficult to swallow and gradually worsened. He came to the hospital and was diagnosed with advanced esophageal cancer after barium meal, electronic gastroscopy and histological examination, and had lost the chance of surgery.  Due to the narrowing and obstruction of the esophagus caused by the lesion, the patient could not eat normally and could only eat a small amount of rice soup or water every day, so he was losing weight and his general condition was poor. The key to treatment was to solve the patient’s “eating” problem first. To solve this problem, the interventional surgeon decided to perform an endoesophageal stenting procedure.  After adequate preoperative preparation, the patient was placed on his side on a DSA bed under fluoroscopic surveillance: the surgeon delivered an ultra-smooth thin guidewire into the esophagus through the patient’s mouth and passed through the obstructed segment of the stenosis, and then fed a delivery device containing an esophageal endoprosthesis (18x100mm) along the guidewire. After accurate positioning, the endoprosthesis was released in the stenotic segment, allowing the stent to extend 2cm beyond each end of the stenosis. The procedure took only about half an hour, and the patient was able to eat soft food 2 hours after the procedure. After two days of recovery treatment, the patient’s dysphagia was completely relieved, his nutritional status gradually improved, and his quality of life was greatly improved.  Knowledge: Endoesophageal stenting can quickly and effectively relieve dysphagia, ensure sufficient nutrition, prolong patients’ lives, or lay the foundation for further treatment for frail or elderly patients with esophageal strictures and those who are not suitable for surgical treatment. Besides being applied to palliative treatment of advanced esophageal cancer, this technique can also be used to treat many cases of inability to eat, such as esophagus-tracheal fistula, post-operative anastomotic stricture of the esophagus, and burned esophageal stricture.