Oesophageal intubation was performed for 324 patients with advanced squamous cell carcinoma of the oesophagus. Peroral pulsion and traction techniques were used. There were 88 deaths in hospital (mortality rate, 27 per cent). The mortality rate did not appear to be directly related to the general condition of the patient or to the experience of the operator. Adequate palliation of dysphagia was achieved in 61 per cent of intubated patients, but a high rate of late complications impaired the quality of life following intubation. It is concluded that the insertion of an oesophageal tube was neither a safe nor satisfactory method for palliation of malignant dysphagia.
One hundred and three patients with proven oesophageal cancer were evaluated prospectively by clinical examination, upper gastro‐intestinal barium studies and computed tomography (CT), The accuracy of each method in assessing the extent of disease was determined by correlation with findings at bronchoscopy (100 patients), thoracotomy (26 patients) and laparotomy (63 patients). The results indicated that CT will accurately demonstrate mass invasion of cancer into mediastinal structures. But the absence of fat‐planes on CT is the least reliable indication of spread into pen‐oesophageal soft tissues. Early mediastinal infiltration is best assessed by analysis of the oesophageal axis on barium swallow and the patient's symptoms. Computed tomography is not helpful in the diagnosis of mediastinal node metastases. Barium studies of the proximal stomach will accurately identify (and CT reliably exclude) local tumour extension into the stomach. CT can frequently fail to detect malignant abdominal lymphadenopathy in cachexic patients.
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