Postoperative care for esophageal stenting

  After stent placement, the patient was placed in a flat position with the head of the bed elevated by 10° to prevent displacement and slippage of the stent before complete expansion. Fasting and drinking for 2 hours after surgery to avoid choking into the trachea; drinking more hot water to make the stent expand to the best state; liquid-based food for 1 week after surgery, with food temperature at 40~50℃, avoid cold diet below 5℃. Gradually transition to semi-liquid or semi-solid food, 1 month later can enter the general diet. Drink more water after meals. Patients should eat gradually, in small amounts, chew and swallow slowly.  Complications are: ① Nausea and vomiting: due to stent stimulation, especially the long frame over 10 cm is prone to occur. Administer metoclopramide intramuscularly to see if any stent comes out with vomiting.  ② Food impaction Patients eat high-fiber food, after surgery, patients should be advised to avoid cold diet, choose low-fiber, peeled, easily digestible warm food swallowed in small bites, drink more water after meals, after the occurrence of impaction can be recanalized by endoscopy.  ③ Pain: give pethidine intramuscularly. Chest pain caused by gastric and esophageal reflux can be added with acid suppressants and pro-gastric power preparations.  ④Stent displacement or slippage: mainly related to the type of stent, release technique, violent vomiting and premature consumption of solid food. In order to prevent stent displacement and slippage, the patient was instructed to lie still for 24 h. After 8 h postoperative, he started to eat liquid food, and after 24 h, he started to eat semi-liquid food, and on the third day, he was instructed to eat regular food. At the early stage of eating, the food should be slow, fine and soft, avoid coarse fiber hard food, such as leek, beef, etc.; the diet should be warm, avoid cold drinks and cold food to prevent the stent from displacement, dislodgement or deformation, if the patient vomits violently, symptomatic treatment should be timely. Avoid patients’ violent cough and vomiting and strengthen respiratory care after surgery. Give anti-inflammatory and cough suppressant treatment to patients with cough.  ⑤ Restenosis. Bleeding.  ⑥Reflux esophagitis: anti-reflux stent with membrane should be placed for lower esophageal segment and cardia tumor.  (vii) Recurrent esophageal fistula occurs in cases with stiffer and more tense stents. Repositioning via endoscopy.