Palliative treatment of esophageal cancer: self-expanding metal stents versus Postlethwait technique.
OBJECTIVE
The development of new techniques for palliation of esophageal carcinoma with lower morbidity and mortality than surgical procedures.


METHODS
Between 1981 and 1994, 258 patients with esophageal and cardiac cancer were treated in our Department. We selected two groups: Group A, 25 patients underwent a by-pass with an isoperistaltic gastric tubular (Postlethwait technique) and, group B, in 30 patients we placed 35 autoexpandable esophageal stents. We subsequently performed a retrospective study.


RESULTS
In group A, dysphagia was not relieved in 6 patients (24%) and we found no complications in 18 patients (72%). The hospitalization period ranged from 18-50 days. Hospital mortality rate was 24% (6 patients). Mean survival was 5.4 months (range: 3-9 months). All patients in group B, except for 2, were relieved of dysphagia. Two patients (6.6%) died in the immediate post-intubation period though none of the deaths were related to technical complications. Hospitalization period ranged from 5-12 days. Mean survival was 6 months (range: 12 days to 9 months).


CONCLUSIONS
Currently, surgical by-pass procedures are restricted to the patient with an incurable disease not identified until operation time.
Cantero
R
R
II Department of Surgery, San Carlos University Hospital, Madrid, Spain.
Torres
A J
AJ
Hernando
F
F
Gallego
J
J
Lezana
A
A
Suarez
A
A
Balibrea
J L
JL
D000368:Aged; D000369:Aged, 80 and over; D002299:Cardia; D003680:Deglutition Disorders / Q000401:mortality / Q000628:therapy; D004938:Esophageal Neoplasms / Q000401:mortality / Q000628:therapy*; D004940:Esophageal Stenosis / Q000401:mortality / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D011474:Prosthesis Design; D012189:Retrospective Studies; D015607:Stents; D015996:Survival Rate; D016896:Treatment Outcome