[Endoscopic palliation of dysphagia due to anastomotic recurrences after esophageal surgery and total gastrectomy due to carcinoma].
BACKGROUND
Dysphagia is the main symptom of locally recurrent esophageal and gastric carcinoma and generally suggests extensive disease. The safety and efficacy of endoscopic palliation in patients who developed locally recurrent disease after surgery is evaluated.


METHODS
Twenty-six males and 12 females, with an average age of 63.5 years were included in the patients group. In 12 patients there was an esophago-gastric anastomosis, in 26 an esophago-jejunostomy, after total gastrectomy. Anastomotic recurrences were divided into predominantly polypoid (16 cases) and predominantly stenosing (22 cases). Three treatment modalities were employed: endoscopic dilation (6 cases), Nd-Yag laser therapy (16 cases) and prostheses (16 cases).


RESULTS
Successful endoscopic treatment was obtained in 33 out of 38 patients (86.8%). Major complications occurred in 5 patients (15%) with a mortality rate of 6%.


CONCLUSIONS
The endoscopic palliation is effective. Technically, endoscopic treatment is easier to perform, with better results, when dealing with polypoid rather than stenosing recurrences.
De Palma
G D
GD
Cattedra di Chirurgia dell'Apparato Digerente Servizio Centralizzato di Endoscopia Digestiva, Università degli Studi Federico II, Napoli.
Sivero
L
L
Galloro
G
G
Abbruzzese
P
P
Siciliano
S
S
Richiello
A
A
Catanzano
C
C
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D003680:Deglutition Disorders / Q000209:etiology / Q000601:surgery*; D004106:Dilatation; D004724:Endoscopy; D004938:Esophageal Neoplasms / Q000601:surgery*; D005260:Female; D005743:Gastrectomy; D006801:Humans; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D010166:Palliative Care; D019736:Prostheses and Implants; D013274:Stomach Neoplasms / Q000601:surgery*