Expandable esophageal wire stents.
Esophageal endoprostheses or stents have been used successfully for more than 100 years in patients with esophageal or gastroesophageal (GE) junction cancer. In recent years, many manufacturers have produced these stents in various styles and materials, but the most innovative design is the expandable wire mesh stent. At Virginia Mason Medical Center, The Schneider Wallstent (Minneapolis, MN) and the Wilson Cook Z stent (Winston-Salem, NC) have been placed in a series of patients with obstructing or fistulizing neoplasms of the esophagus, GE junction, stomach, lung, or mediastinum. The nursing care of these patients requires meticulous attention to airway maintenance and oral suction. Stents cannot be repositioned after total deployment; thus, the nurse plays an important role in assuring correct placement. During and after the endoscopy, the nurse must be alert to any signs of possible complications, including bleeding, perforation, dyspnea from tracheal compression, and stent malposition. Several case studies are presented in this article, noting the patients' histories, indications for stent placement, and nursing care pre-, intra-, and postprocedure.
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D000328:Adult; D000368:Aged; D004867:Equipment Design; D004938:Esophageal Neoplasms / Q000451:nursing* / Q000601:surgery*; D004945:Esophagoscopy / Q000451:nursing*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents; D016896:Treatment Outcome