title: Push-through intubation: effective palliation in 409 patients with cancer of the esophagus and cardia.
abstract: Between 1980 and 1989, 355 patients with cancer of the esophagus and 54 with cancer of the cardia underwent push-through intubation because of advanced tumor stage or medical contraindications to tumor resection. In 36 other patients (8.1%), the attempt at transtumoral intubation failed. The hospital mortality rate after intubation was 3.4%. The following complications were observed: hemorrhage in 2.0% of the patients, esophageal perforation in 4.9%, tube dislodgment in 12.7%, and tube obstruction in 4.4%. Early resumption of semisolid oral feeding was possible in 80% of the discharged patients. The actuarial 1-year survival rate was 7.7% and the median survival, 3.9 months. In conclusion, push-through intubation represents a valid therapeutic choice, which is indicated mainly for patients with a long, infiltrating, and circumferential stricture of the thoracic esophagus or cardia that is inoperable and for patients with an esophagorespiratory or esophagomediastinal fistula.
authors.affiliation: First Department of Surgery, University of Padua, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Cusumano
authors.forename: A
authors.initials: A
authors.lastname: Ruol
authors.forename: A
authors.initials: A
authors.lastname: Segalin
authors.forename: L
authors.initials: L
authors.lastname: Norberto
authors.forename: M
authors.initials: M
authors.lastname: Baessato
authors.forename: E
authors.initials: E
authors.lastname: Tiso
authors.forename: A
authors.initials: A
authors.lastname: Peracchia
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000628:therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004938:Esophageal Neoplasms / Q000401:mortality / Q000628:therapy*; D004947:Esophagus; D005260:Female; D006801:Humans; D007440:Intubation / Q000009:adverse effects / Q000379:methods; D008297:Male; D008875:Middle Aged; D010166:Palliative Care