New method for ambulatory intubation of nonresectable oesophageal tumours. Experiences in 247 consecutive cases

1993 
Abstract Palliative treatment of oesophageal tumours represents an unsolved problem, a field of controversies focused on cost-benefit relation. As a consequence of the continually rising number of advanced oesophageal malignancies in Hungary, enhanced requirements for tube insertion to maintain swallowing capacity emerged at our unit during the late 1980s. In 1990 a new method for tube insertion was elaborated and introduced. Continuous dilatation by an Eder-Puestow device, followed by endoesophageal tube placement with the help of a rigid oesophagoscope under X-ray control enabled us to apply this method routinely as an ambulatory procedure. Two hundred and forty-seven patients were treated, 196 cases underwent 'same day' interventions without hospitalization and a further 51 patients had been admitted earlier for diagnostic purposes. No lethal complications occurred. Twenty-seven patients with oesophagobronchial fistulas were treated successfully; 19 of them ambulatorily. The complications experienced were: perforation (1), tube displacement (7), obstruction (6) and bleeding (2). Comparing our earlier experiences with tube insertion via gastrotomy ('pull through' method) to this new method, the latter shows the following advantages: (a) no direct mortality, (b) low postoperative morbidity, (c) minimal complication rate, and diminished hospital costs up to 95%. Tube implantation promotes intracavital afterloading radiotherapy of tumours. Results in 62 patients show improvement of survival rate from 5.5 months (controls) to 11.7 months respectively.
    • Correction
    • Source
    • Cite
    • Save
    • Machine Reading By IdeaReader
    20
    References
    1
    Citations
    NaN
    KQI
    []