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Oesophageal stent insertion

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What is an oesophageal stent insertion?


The oesophagus (gullet) is a hollow, muscular tube which takes food from the mouth down to the stomach. If it becomes blocked by a tumour or narrowed following radiotherapy (stricture) this causes a problem with swallowing. One way of overcoming this problem is by inserting a stent. Food can then pass down the oesophagus more easily.


    Why do I need an oesophageal stent insertion?


    The doctors in charge of your case will have carried out some tests such as a CT Scan, endoscopy or a barium swallow test to determine the cause of the blockage and have decided this is the best treatment for you.


      Who will be doing the oesophageal stent insertion?


      A specialist doctor called an Interventional Radiologist. Interventional radiologists have special expertise in using X-ray equipment and in imaging procedures.


        Where will the procedure take place?


        In the imaging department, in a special Interventional Radiology (IR) Procedure Room which is designed for these specialised procedures. You will be checked into the department by a nurse, who will ask some medical questions and fill out some paperwork. The interventional radiologist will then talk to you about the procedure, where you will have the opportunity to ask any questions or raise any concerns. Only if you are happy to continue with the procedure will you be asked to sign the consent form.


          What happens during the procedure?


          You will lie on the x-ray bed, on your back or your side.

          • You will have a needle put into the vein in your arm for sedation and pain relief and you will have some local anaesthetic spray to numb your throat. You will have a mouth guard in to keep your mouth open for the procedure.
          • A fine catheter (tube) will then be passed down the oesophagus and through the blockage. The radiologist will inject x-ray dye to assess where the stent needs to be placed.
          • The catheter will be withdrawn and a stent placed into your oesophagus. You may gag slightly during the procedure; this is quite normal and will not interfere with your breathing.

            What is the preparation for the procedure?


            To prepare for the procedure you will need to make sure you do the following:

            You will need to have a blood test before your procedure. Please let us know if you are taking any antiplatelet medicines (for example, Aspirin, Clopidogrel) or any medicines that thin the blood (for example, Warfarin), as these may need to be withheld temporarily before the procedure. Call the IR department for advice as soon as you get your appointment letter on 01273 696955 Extension. 64240/64278 and ask to speak to one of the IR nursing team. You cannot eat or drink anything (except water) for four hours before your procedure.

            You can drink water up to two hours before your procedure.

            You will need a responsible adult to take you home if you are going to be a day case procedure.

            You may be admitted to a ward for an overnight stay following the procedure, depending on certain factors which we will discuss with you prior to your appointment.


              Will it hurt?


              It may hurt a little until the stent fully expands, but in the majority of cases the discomfort resolves within 24 to 48 hours. Any pain you may experience should be reported straight away to your nurse and then pain killers can be given to help control this.


                What happens afterwards?


                You will be required to recover in our recovery area on a trolley and will stay in the department for up to 4 hours after the procedure. The nurses will carry out routine observations, blood pressure, pulse and monitor your swallowing. You will be seen by a dietician before you go home. Please arrange for someone to pick you up and take you home and remain with you for 24 hours following the procedure, as you must not drive or use public transport or be at home alone.


                  How long will it take?


                  Whilst every patient and every patient’s situation is different we allow an hour for the procedure.


                    How long will the stent stay in?


                    The doctors looking after you will discuss this with you. It may only need to stay in a short time, or the stent may need to stay in permanently. If you have a biodegradable stent inserted it will dissolve in approximately 3-4 months. You may be offered another stent insertion if your symptoms persists.


                      How soon can I eat or drink?


                      You are allowed to drink once the sedation and throat spray have worn off. When you can comfortably manage drinks you should be able to build up slowly to foods with a soft and moist consistency. You will be seen by a dietician for more advice before you go home.


                        What are the possible risks?


                        Oesophageal stent insertion is generally a safe procedure, but complications can arise, as with any medical treatment:

                        • Occasionally a little bleeding can occur during the procedure but this is rarely a problem.
                        • Very rarely, the placement of a stent may cause a tear in the oesophagus.Your swallowing problems may return.

                        This may happen for several reasons:

                        • Food may occasionally stick inside the stent causing a blockage.
                        • Your tumour may grow above or below the stent. This can be treated by placing a new stent to open up the oesophagus again.
                        • Very rarely, the stent may slip out of position, and if this happens another stent need placing.

                        Despite the above mentioned complications, the risks are small and the procedure is relatively safe.


                          Following the procedure


                          You will be observed for a up to 4 hours and may go home the same day.

                          You will need to rest for the remainder of the day, and possibly the next day depending on your recovery. You can then resume your normal activities if you are feeling well enough.

                          You will need to have a responsible adult to take you home and be with you overnight.

                          Continue with your normal medication as prescribed, unless otherwise advised.

                          If you are having some mild pain you can take over-the-counter painkillers (follow the instructions on the packet).

                          Do not drive for 24 hours after the procedure.

                          You will be seen by a dietician after the procedure for advice on your diet.

                          If you feel you need urgent medical attention or are having increased difficulty in swallowing and breathing or pain in your chest and/or abdomen please contact the IR department Monday – Friday 9am – 5pm, your GP, or go to your nearest A&E department.

                          Finally

                          Some of your questions should have been answered by this leaflet but remember that this is only a starting point for discussion about your treatment with the team looking after you.

                          Make sure you are satisfied that you have received enough information about the procedure before you sign the consent form.

                          Interventional Radiology: 01273 696955 Extension 64240.



                            This information is intended for patients receiving care in Brighton & Hove or Haywards Heath.

                            The information in this leaflet is for guidance purposes only and is in no way intended to replace professional clinical advice by a qualified practitioner.

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