Stent placement for inoperable stomach cancer

The patient has a large tumor compressing the stomach, must eat with a feeding tube, has a stent placed through the endoscope to be able to eat and drink by himself, improve health.

A doctor of Tam Anh General Hospital performs endoscopic gastric stenting for a patient. Photo: Provided by the hospital.

After 24 hours of stenting (metal tube), patient Le Thi Tien (52 years old, Quang Ninh) can practice eating porridge, soft foods. Results of an abdominal X-ray check after 48 hours, the gastric stent expanded through the tumor. The doctors of the Department of Gastroenterology - Hepatobiliary - Pancreas, Tam Anh General Hospital, conducted a catheter removal on the abdominal wall when the patient was fully able to eat. The patient was monitored for the next 24 hours and was discharged in early August with stable health and spirit. After a month, Ms. Tien is now recovering thanks to being able to eat and drink and continue to receive adjuvant chemotherapy.

Ms. Tien recounted, before that, a doctor at a large hospital in Hanoi diagnosed her with gastric cancer causing pyloric stenosis (the condition in which the circulation of food and gastric juice down to the duodenum is obstructed or delayed). ), cancerous lesions invading the abdomen. Doctors could not operate because the tumor was too large, only placed a tube into the intestine to pump food to the body.

The tumor pressed on her entire stomach, making her constantly vomiting and unable to eat by mouth. Her condition was getting worse and worse, she lost 18 kg in 2 months, the foot of the nebulizer was still bleeding, so she went to Tam Anh General Hospital for examination. She was ordered by her doctor to have a gastroscopy to confirm her condition. The results showed that the tumor in the stomach developed into a cancerous ulcer, infiltrating the entire antrum, completely narrowing the stomach, preventing all food from entering the intestine, causing semi-obstruction.

Doctor, Dr. Vu Truong Khanh, Head of Department of Gastroenterology - Hepatobiliary - Pancreas said that in the case of invasive gastric cancer causing pyloric stenosis, surgery is not effective or difficult to perform, especially in the case of gastric cancer. In exhausted patients, the endoscopic gastric stenting method helps to solve the obstruction and improve the quality of life.

With Ms. Tien's condition, the doctor gave her fasting, intravenous nutrition and endoscopic intervention to place stents through the mouth. Just over an hour, doctors placed a stent 12 cm long, with a maximum opening diameter of 2.2 cm, passing through the narrow site caused by the tumor . The metal stent expands in the stomach, allowing food to flow completely down to the intestines.

In the past, for patients with gastrointestinal cancers such as stomach, who are no longer able to operate, it is necessary to insert a tube through the abdominal wall into the small intestine to improve nutrition for the patient. However, food not taken by mouth reduces the patient's quality of life.

Dr. Khanh added that gastric stenting is a minimally invasive technique, often performed in advanced countries around the world, but it is still rarely applied in Vietnam. The method is performed in a short time but requires a team of highly qualified doctors with the support of modern machines.