Esophageal Stent Placement - Small Stent Supports "Life Channel
After the surgery, I am finally able to eat normally. Thank you very much to the doctors and nurses of Director Xu's team. Recently, in the gastroenterology ward, a patient, accompanied by their family, was being discharged from the hospital. The patient expressed gratitude to the medical staff.
It is understood that Mr. Shi has been experiencing discomfort with eating in recent months and has gradually worsened. One month later, he developed difficulty swallowing, and currently has difficulty getting water and eating. The patient underwent chest plain CT scan at the local hospital and found "left hilar mass and thickening of the middle and lower esophageal wall". Gastroscopy revealed "obvious narrowing of the lumen about 30cm from the incisor teeth, and the body cannot pass through. Biopsy pathology suggests esophageal squamous cell carcinoma". Due to the patient's difficulty in eating, weight loss, and gradual deterioration of overall condition, the local hospital suggests transferring to a higher-level hospital for treatment.
After multiple consultations, Mr. Shi, accompanied by his family, visited the Department of Gastroenterology at Henan Chest Hospital. Director of Gastroenterology, Xu Gang, led the attending physician Hua Wei to review medical records and found that the patient had suffered from "Tetralogy of Fallot" since childhood, with a weight of only 34kg and a BMI of 12.0kg/㎡. Recently, the weight loss exceeded 20%, indicating a cachexia state; Chest plain CT scan revealed secondary dilation of the upper esophageal segment due to stenosis in the patient (Figure 1), and severe stenosis of the middle esophageal lumen caused by esophageal space occupation (Figure 2).
Figure 1 Upper Esophageal Stenosis Dilation
Figure 2 Esophageal space occupying stenosis
After comprehensive evaluation of the patient's condition, it was found that the esophagus and hilum of the lungs were occupied, and the cardiopulmonary function was extremely poor. The patient has lost the opportunity for surgery, and according to the opinions of the anesthesia department, the patient is currently unable to undergo gastroscopy under general anesthesia. Faced with the patient's condition and the wishes of their family members, Director Xu Gang's team decided to perform a "sedative and analgesic gastroscopy examination" for the patient, along with an "esophageal stent placement surgery" to relieve esophageal stenosis and restore oral diet. With the collaboration of Director Xu Gang and attending physician Hua Wei from the Department of Gastroenterology, as well as Nurse Zhang Liping and Nurse Zhang Chen from the Endoscopic Diagnosis and Treatment Department, the esophageal stent was successfully inserted into the esophagus and observed unobstructed under the microscope (Figure 3 and Figure 4). The patient resumed their diet that afternoon. After eating, the symptoms of vomiting and choking were significantly reduced, and their mental state improved significantly. They successfully solved the major problem of "difficulty eating" and opened up the "life channel", The quality of life has been improved, and patients and their families have shown satisfactory smiles.
Figure 3 Lower view of gastroscopy operation
(Figure 3A: Irregular new organisms are seen, leading to luminal stenosis, and the pathology shows esophageal squamous cell carcinoma;
Figure 3B: Placement of esophageal stent, unobstructed inside the esophageal stent)
Figure 4 Surgical process of endoscopic esophageal stent placement