A stomach, or gastric, stent is a small, mesh-like tube placed into the upper digestive tract to alleviate a blockage that prevents food and liquids from passing normally. This device is typically inserted using an endoscope, a flexible tube guided through the mouth and down the throat, making the procedure minimally invasive. Its function is to restore the passage through a narrowed segment, often at the junction of the stomach and the small intestine. Stents are most frequently needed due to cancerous tumors, such as those associated with gastric or pancreatic cancer, or severe, non-cancerous scarring known as benign strictures.
Survival Expectations Based on Underlying Diagnosis
The length of time an individual lives after receiving a stomach stent is determined almost entirely by the underlying medical condition, not the device itself. For patients with advanced, unresectable cancers, stenting serves as palliative care to improve quality of life by allowing oral intake. In this malignant context, expected survival is often limited, typically ranging from two to four months, depending heavily on the specific cancer and its stage.
When the stent treats a benign condition, such as a severe stricture caused by inflammation or scarring, the device does not limit life expectancy. The goal in these non-cancer cases may be temporary relief while other treatments are considered, or the stent may remain in place indefinitely. The intervention’s success is measured by two metrics: technical success (correct deployment) and clinical success (the patient’s ability to tolerate food and experience relief from obstructive symptoms). Clinical success rates are generally high, often exceeding 80%.
Immediate and Long-Term Stent Complications
While the stent provides significant relief, its function can be compromised by device-related issues requiring medical intervention. Immediate complications, occurring within the first few days, include a small risk of bleeding or, rarely, perforation during placement. Patients may also experience severe abdominal pain immediately following the procedure as the self-expanding metal stent opens up within the restricted passage.
The most common long-term complications involve the stent becoming blocked or moving out of position. Re-obstruction occurs due to tumor overgrowth (expanding over the ends of the stent) or tumor ingrowth (cancer tissue growing through the mesh of an uncovered stent). Blockage can also result from food impaction, necessitating strict dietary adjustments.
Stent migration, where the device moves from its intended location, occurs in up to 30% of cases, particularly with covered stents. Covered stents prevent tumor ingrowth but provide less friction, making them prone to slipping out of place. If a stent becomes obstructed or migrates, the patient requires a repeat endoscopic procedure for cleaning, repositioning, or replacement.
Follow-Up and Stent Replacement Schedules
Medical surveillance is necessary to ensure the stent’s continued function and manage potential issues. Soon after placement, patients typically undergo imaging, such as an abdominal radiograph, within the first few days to confirm the stent’s correct position and expansion. Subsequent clinical checkups are usually scheduled at intervals of one to three months, involving an evaluation of symptoms and nutritional status.
The durability, or patency, of the stent—the time it remains open—is highly variable and dictates the replacement schedule. In cases of malignant obstruction, the median patency period ranges from four to eight months before re-intervention is necessary. Uncovered stents are susceptible to tumor ingrowth, requiring clearing or placing a second stent, while covered stents have a higher rate of migration.
Daily Living and Dietary Adjustments
Maintaining the stent’s functionality and preventing re-obstruction depends significantly on strict adherence to specialized dietary guidelines. The diet must focus on foods that are soft, moist, or pureed, reducing the risk of food particles becoming lodged in the mesh. Patients should eat five to six small, frequent meals throughout the day rather than a few large ones.
Patients must thoroughly chew all food and take small bites, ensuring the consistency is easily swallowed. Foods that are tough, fibrous, stringy, or contain seeds or skins should be strictly avoided due to the high risk of impaction. To aid passage, food should be moistened with gravy, sauces, or liquids.
Specific examples of foods to limit or eliminate include:
- Nuts
- Popcorn
- High-fiber cereals
- Fresh crunchy vegetables
- Tough meat chunks
Remaining upright for 30 to 60 minutes after eating helps the food move through the stent more efficiently and assists in managing reflux, which can be a common post-stenting discomfort.