What Can I Expect After Esophageal Stent Placement?

The esophageal stent is made of nickel-titanium memory alloy, and some stent surfaces are also covered with a silicone rubber film to close the mesh of the naked frame. Proliferative lesions cannot enter the interior of the lumen through the mesh and do not cause re-stenosis.

The esophageal stent is made of nickel-titanium memory alloy, and some stent surfaces are also covered with a silicone rubber film to close the mesh of the naked frame. Proliferative lesions cannot enter the interior of the lumen through the mesh and do not cause re-stenosis.

Chinese name

Esophageal stent

Curing disease

Esophageal cancer

Materials

Nitinol memory alloy, etc.

main feature

Biocompatibility and corrosion resistance, etc.

Esophageal stent application background

Cancer is one of the top ten leading causes of death in China, and cancers of the digestive tract, including esophagus, stomach, and colorectal cancer, cause high annual mortality. These cancers often cause obstruction of the digestive tract, affect eating or defecation. In the past, when patients faced the obstruction of the digestive tract and could not remove the tumor by surgery or other methods, they usually solved the problem of nutrition or defecation by intestinal or gastric ostomy. The biggest problem with esophageal cancer is obstruction, but the gastrostomy still cannot allow the patient to eat by mouth. In order to allow patients to eat by mouth to satisfy their appetite, the esophageal stent used to open up the tumor obstruction began to develop. Early esophageal scaffolds were made of harder plastic. Patients will have significant pain after placement, and there are many complications. The patient's acceptance is not high. In recent years, due to the advancement of medical materials, many alloy materials have begun to be used in medical treatment. The alloy metal stent is a kind of nickel-titanium alloy product that can expand by itself, has elasticity, flexibility and high memory. It is applied to esophageal tumors, which opens the door for esophageal stents with low pain and low complications.

Main features of esophageal stent

The shape of the esophagus stent is a cylindrical shape with a bell mouth, a cup shape, a sphere, a mushroom shape, etc. at one or both ends (as shown in Figure 2), and generally has the following characteristics:

(1) The titanium-nickel memory alloy self-expanding stent has excellent biocompatibility and corrosion resistance, and has memory characteristics and super elasticity. The stent is in a softened state in the 0-10 ° C (or ice water) environment. The shape can be changed within a certain range, and it is easy to put in the implanter. When the stent is released from the implanter in the human body (ambient temperature is above 33 ° C), it can gradually return to its original state. The stent produces a continuous soft radial expansion force, which acts on the inner wall of the esophagus, gradually expanding the stenosed area and restoring patency.

(2) The stent has good superelasticity at body temperature, and can obey the peristalsis of the esophagus, so as to keep the esophagus unobstructed without much discomfort. The structure of the woven support is specially designed to reduce patient discomfort.

(3) Both ends of the stent are smooth without sharp corners or burrs, which significantly reduces damage to the wall of the esophagus.

(4) The silicone rubber film coated on the surface of the stent has good biocompatibility, which can effectively prevent the granulation growth of the esophagus wall, gastric juice and food from flowing back.

Figure 2. Different shapes of esophageal stent

Main classification of esophageal stent

(1) Knitted esophageal stent

Knitted esophageal stent has all the functions of ordinary esophageal stent. The biggest feature is that the specially designed structure of the stent can adapt to the peristalsis of the esophagus, the damage to the esophagus is small, and the foreign body sensation is effectively reduced. Knitted esophageal stent adopts bundled inserter to place the stent, which is more accurate, convenient and safe when placing.

Figure 3. Knitted esophageal stent

(2) Recyclable esophageal stent

Recyclable esophageal stent is designed for benign stenosis and short-term occlusion of fistula. The stent is fully covered with stent, which covers the end edge of the stent to minimize the occurrence of irritative hyperplasia and facilitate recycling. The recycling line is convenient for tightening the bulged end edge of the bracket during recycling, and the recycling is convenient; the bracket with the external recycling line is extremely convenient for recycling; the bracket without the external recycling line provides special recycling tools to facilitate recycling.

Figure 4. Recyclable esophageal stent

(3) Membrane anti-reflow bracket

On the basis of the esophagus and membrane stent, the membrane-added anti-return stent adds a reflux valve, which can mimic the action of the cardia and reduce the incidence of complications such as reflux esophagitis.

Figure 5. Membrane anti-reflow bracket

(4) Stomach block fistula

The gastric fundus fistula stent has a unique mushroom-shaped umbrella, which fits tightly with the stomach wall at the bottom of the stomach, which effectively prevents gastric contents from flowing back into the thorax through the fistula; Large, stable and stable.

Figure 6. Stomach block fistula

Esophageal stent placement method

Esophageal stent is used for dilatation treatment of esophagus, cardia and anastomotic stenosis, and occlusive fistula treatment of esophageal fistula. The method of placing is as follows:

Under X-ray, first insert the catheter through the mouth (Figure 7A), reach the stomach through the esophagus, and then insert the hard guide wire to the stomach (Figure 7B); in severe stenosis, insert the guide wire into the stomach and then follow the guide wire Insert the catheter, exchange the hard guide wire through the catheter, and withdraw the guide wire disk from the catheter after the catheter (Fig. 7C). Insert the inserter along the guide wire to confirm that the position is correct and release the stent (Fig. 7D).

Figure 7. Esophageal stent placement steps

Esophageal Stent Extended Reading

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[3] Yang Haiming. Clinical application of stent graft in the treatment of esophageal cancer and tracheal fistula [J]. Qinghai Medical Journal, 2014, 44 (5): 15-16

[4] Wang Yubo, Zhu Weimei, Sun Ping, et al. Treatment of esophageal stenosis with esophageal stent placement under nasal gastroscopy [J]. Chinese Journal of Disability Medicine, 2013, 21 (2): 55-56

[5] Cui Bing, Han Song, Cheng Liang. Experience of intraluminal stenting and gastric tube placement in 26 cases of esophageal and gastric cardia cancer [J]. Jilin Medical Journal 2014, 35 (32): 7160-7161

[6] Chen Tianfu. Feasibility of esophageal stent placement in primary hospitals for advanced esophageal cancer [J]. China Practical Medicine, 2012, 7 (23): 114-115

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[8] Zhou Yu, Luo Liangde, Yang Jian. Efficacy and safety of esophageal stent grafting and dilatation therapy for malignant esophageal stricture. Hebei Medical Journal, 2014, 20 (3): 488-491