This information explains your esophageal stent placement and home care instructions.
Your esophagus is the tube that carries food and drink from your mouth to your stomach. Cancer of the esophagus can make it hard to swallow food and saliva. This is called dysphagia. An esophageal stent is a hollow tube that can be placed in the area of the tumor. It makes it easier to swallow. During stent placement, a balloon will be used to expand the part of your esophagus narrowed by a tumor. The stent will then hold it open. Having a stent will not affect your ability to receive cancer treatment such as chemotherapy or radiation therapy.
Esophageal stents are usually easy to place. They are inserted through the mouth without the need for surgery. Most patients return home on the same day. It is possible that your doctor could decide that you should be admitted to the hospital for close observation.
1 Week Before Your Procedure
You may need to stop taking or change the dose of some of your medications before your procedure. We have included some common examples below.
- If you take medication to thin your blood, such as to treat blood clots or to prevent a heart attack or stroke, ask the doctor who prescribes it for you when to stop taking it. Some examples of blood thinners are warfarin (Coumadin®), dalteparin (Fragmin®), heparin, tinzaparin (Innohep®), enoxaparin (Lovenox®), clopidogrel (Plavix®), and cilostazol (Pletal®). There are others, so check with your doctor if you are not sure.
- If you take insulin or other medications for diabetes, you may need to change the dose. Ask the doctor who prescribes your diabetes medication what you should do the day before and the morning of your procedure. If you take metformin or a medication that contains metformin, do not take it the day before or the day of your procedure.
- If you have an automatic implantable cardioverter-defibrillator (AICD), you need to get a clearance letter from your cardiologist (heart doctor) before your procedure.
- If you’ve had chest pain, trouble breathing that is new or worse, or have fainted in the last 6 weeks, you will need to get a clearance letter from your doctor before your procedure.
- Your MSK doctor’s office must receive your clearance letter at least 1 day before your procedure.
You must have someone 18 years or older take you home after your procedure. If you don’t have anyone, call one of the agencies below. They will provide someone to accompany you home, however there is a charge for this service and you will also need to provide transportation.
In New York:
Partners in Care 888-735-8913
Prime Care 212-944-0244
In New York or New Jersey:
Caring People 877-227-4649
3 Days Before Your Procedure
The Day Before Your Procedure
- Do not eat anything after midnight the night before your procedure. This includes hard candy and gum.
- Between midnight and up until 2 hours before your scheduled arrival time, you may drink a total of 12 ounces of water (see figure).
- Starting 2 hours before your scheduled arrival time, do not eat or drink anything. This includes water.
The Day of Your Procedure
- Take the medications you were instructed to take the morning of your procedure with a few sips of water.
- Do not put on any lotion, cream, powder, make-up, or perfume.
- Remove any jewelry, including body piercings.
- Leave all valuables such as credit cards and jewelry at home.
- If you wear contact lenses, wear your glasses instead.
- A list of the medications you take at home
- Your rescue inhaler (such as albuterol for asthma), if you have one
- A case for your glasses
- Your Health Care Proxy form, if you have completed one
Parking at Memorial Sloan Kettering is available in the garage on East 66th Street between First and York Avenues. To reach the garage, enter East 66th Street from York Avenue. The garage is located about ¼ block toward First Avenue, on the right (north) side of the street. A pedestrian tunnel connects the garage to the hospital. For questions about pricing, call 212-639-2338. The line for the parking garage can be long, especially in the middle of the day. You may wish to consider using one of the nearby commercial garages, which are located on East 69th Street between First and Second Avenues and on East 65th Street between First and Second Avenues.
Your procedure will take place in the Endoscopy Suite at the main hospital, which is located at 1275 York Avenue. Take the M elevator to the 2nd floor and enter the Endoscopy Suite through the glass doors.
If you parked in the garage on 66th Street and York Avenue, follow the signs to the A elevator. Take the A elevator to the 2nd floor, then follow the signs to the M building and enter the Endoscopy Suite through the glass doors.
- An intravenous (IV) needle will be inserted into a vein. You will get fluid through your IV. You will also get medication through the IV to help reduce any discomfort and make you sleepy.
- You will lie on your back or left side during the procedure.
- A mouth guard will be placed over your teeth to protect them. If you wear dentures, they will be removed right before the procedure.
- Your doctor will first examine the area that is blocked. This will be done with an endoscope. It is a flexible tube that goes through you mouth and esophagus.
- Your doctor may need to to dilate your esophagus before the stent is placed. This can be done with special balloons or soft, flexible, rubber tubes.
- Your doctor will insert and position the stent with the help of fluoroscopy (a real-time x-ray).
After Your Procedure
- You will be taken to the Post-Anesthesia Care Unit (PACU). A nurse will check your pulse, breathing, and blood pressure often.
- You will remain in the PACU until you are fully awake. You will then be given a beverage. Do not eat solid food until the day after your procedure.
- Some patients may feel mild to moderate discomfort in the chest. This is typically described as a feeling of pressure or soreness. These symptoms are usually relieved with mild pain medications such as acetaminophen (Tylenol®). Your doctor may prescribe other pain medication. In some patients, the pain is severe. It requires a short stay in the hospital for pain relief.
- You may also experience a sore throat for up to 24 hours. This discomfort can be relieved with lozenges and cool liquids.
- Your nurse will give you discharge instructions before you go home.
- Your doctor will speak with you before you are discharged.
Home Care Instructions
- You may resume your normal activities in 24 hours.
- On the day of your stent placement, take liquids by mouth. You can also have soup, oatmeal, or cream of wheat, but do not eat solids. You can begin to eat soft foods the following day. On the third day, you can eat solid food.
- Do not drink alcohol for 24 hours.
- When you resume your normal diet, eat small pieces of food and always chew them well before swallowing.
- Taking fluids often throughout your meals will help food pass through the stent. Carbonated beverages such as cola or ginger ale also help food pass through.
- Always eat in an upright position. Gravity will help food pass through your esophagus and stent.
- Remain in a sitting position at least 2 hours after each meal. This will help prevent the reflux of food, a burning, or full feeling pushing up from your stomach.
- Sleep with a wedge to elevate the head of your bed 30 degrees or more. This decreases the chance of reflux.
- You can swallow pills or capsules whole. Drink at least 4 ounces of water after swallowing them.
Call Your Doctor or Nurse if You Have:
- Chest pain does not get better with acetaminophen or the medication your doctor prescribed
- Difficulty or pain while swallowing that persists more than 1 day
- Abdominal pain, bloating, or hardness
- Back or shoulder pain
- Difficulty breathing
- Black or dark stools
- Weakness, faintness, or nausea
- Chills or a fever of 101° F (38.3° C) or higher
- Vomiting of food or blood
- Any problem you did not expect
- Any questions or concerns