[The palliative treatment of esophageal tumors with the laser (Nd-YAG). The results of an initial experience].
Palliative treatment of esophagus tumors leads to a remarkable improvement of dysphagia allowing oral feeding, prolonging the survival period and improving patient's quality of life. We have treated 30 patients with such tumors, who had previously been discarded for surgical therapy, with Nd-YAG laser through endoscopy. The procedure could be ended, so the dysphagia improved remarkably, in 23 patients (77.7%). Survival mean length was 7,3 months (range: 2,5-22 months) in eleven patients who already died when this study was finished, and 6,5 months (range: 2,5-10 months) in the remaining 12 patients. Five patients required the implant of a esophageal prosthesis as result of a proneness of the tumor to produce stenosis again. Follow-up visits were done regularly every 1 to 1.5 months. In summary best results were obtained on medial and distal thirds of the esophagus, where dilatation previous to laser therapy is easier, obtaining an important improvement of dysphagia. If the tumor has a localization in the upper part of the esophagus or if it has its origin in the stomach and later on it invades cardias, both cases pose more difficulties to the treatment with laser, which determines the results, so another alternative technique to feed the patient may be used.
Meroño
E
E
Servicio de Gastroenterología, Hospital Ramón y Cajal, Madrid.
Martín de Argila
C
C
García-Plaza
A
A
D000230:Adenocarcinoma / Q000401:mortality / Q000532:radiotherapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000532:radiotherapy*; D004938:Esophageal Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D020701:Esophagoscopes; D004945:Esophagoscopy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods*