Palliative endoscopic treatment of esophageal neoplastic stenosis

The authors examined a series of 231 patients suffering from unoperable neoplastic dysphagia of the esophagus and treated using prevalently palliative endoscopic methods (photocoagulation and/or intubation) during the period 1980-1991. They draw the following conclusions: a) endoscopic methods are b...

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Bibliographic Details
Published inMinerva gastroenterologica e dietologica Vol. 39; no. 1; p. 11
Main Authors Foco, A, Garbarini, A, Serenthà, U, Giordano, O, Rozzio, G, Leli, R, Fontana, D, Voghera, P, Graziano, L, Galasso, F
Format Journal Article
LanguageItalian
Published Italy 01.03.1993
Subjects
Esophageal Neoplasms - complications
Esophageal Stenosis - etiology
Esophageal Stenosis - mortality
Esophageal Stenosis - therapy
Esophagoscopy - adverse effects
Esophagus
Humans
Intubation
Light Coagulation
Middle Aged
Palliative Care
Prostheses and Implants
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Summary:The authors examined a series of 231 patients suffering from unoperable neoplastic dysphagia of the esophagus and treated using prevalently palliative endoscopic methods (photocoagulation and/or intubation) during the period 1980-1991. They draw the following conclusions: a) endoscopic methods are better than surgical techniques; b) there are a greater number of indications for endoscopic intubation than for photocoagulation (approximately 2 to 1); c) some situation which are indicated for photocoagulation are not contraindicated for intubation; d) the sole contraindication for intubation is stenosis in which the proximal limit is less than 2 cm from the upper esophageal sphincter; e) contraindications for photocoagulation are long stenoses and/or those of the infiltrating type, and/or involving the upper third of the esophagus; f) sometimes the two methods may be complementary in the sense that intubation may be preceded by a few photocoagulation sessions in order to necrotize the vegetating portion of an infiltrating tumour; g) it is best to choose intubation wherever possible since this technique is less expensive and the quality of remaining life better, even if the percentage of severe and generally fatal complications (perforation) is still too high; h) the possible introduction of expandable metal prostheses might increase indications for intubation and reduce the number of severe complication.
ISSN:1121-421X