Palliative endoscopic management of obstructive esophagogastric cancer: laser or prosthesis?

Buset, Michel; Marez, B. Des; Baize, Michel; Bourgeois, Nadine; Boelpaepe, C. De; Toeuf, Jean De; Cremer, Michel

doi:10.1016/s0016-5107(87)71638-1

Cited by 76 publications

(15 citation statements)

References 12 publications

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“…Only a small minority of patients are able to return to an entirely normal diet with the majority being limited to semisolids [22]. Three prospective randomised studies have reported that patients treated with laser achieve better palliation [23, 24, 25]. However, for smaller centres, intubation is likely to be the only treatment option [11]although it provides less quality of palliation and carries a higher complication rate.…”

Section: Discussionmentioning

confidence: 99%

Use of Laser in the Relief of Malignant Dysphagia: A District Hospital Experience

Aly¹,

Burgess²

2002

Dig Surg

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Background: Endoscopic laser treatment offers rapid relief from dysphagia. The major drawback of laser therapy is the need for repeated treatment at 4- to 6-week intervals. Laser therapy is often done in tertiary referral centres and is said to require special expertise that is not available in many peripheral hospitals. For smaller centres, intubation is likely to be the only treatment option even though it gives less quality of palliation. Aim: To report the experience of a district general hospital in laser treatment of malignant dysphagia. Methods: A retrospective study on patients who had laser therapy for relief from malignant dysphagia from march 1995 to January 2000 was performed in a district general hospital in the UK. Results: Forty patients (25 males and 15 females) with histologically proven oesophageal carcinoma were unsuitable for surgical resection. Trainees, under supervision, did 20% of the sessions. Treatment was done on a day case basis with no outpatient follow-up. The patients had direct access to the service whenever dysphagia got worse. The median number of sessions per patient was 4 (range 1–13). The median palliation period per session was 7 (range 1–32) weeks. The median total palliation period was 7 months. There was no procedure-related mortality. Conclusion: Laser therapy is a safe, easy to teach and learn technique for relief from malignant dysphagia. It can be done on a day case basis with minimum need for follow-up and hospital visits. Such a service could be provided in a district general hospital set-up once equipment and experience are available, thus saving patients from having to travel to specialist units.

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Section: Discussionmentioning

confidence: 99%

Use of Laser in the Relief of Malignant Dysphagia: A District Hospital Experience

Aly¹,

Burgess²

2002

Dig Surg

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“…Reoperation is seldom justified because of the limited life expectancy. Anastomotic recurrence may be amenable to endoscopic laser therapy if the obstruction if predominantly intraluminal and exophytic [1,4,7,8]. Tumor invasion of the efferent loop is even more difficult to manage as the main bulk of the recurrent tumor is extraluminal or from extrinsic compression.…”

Section: Discussionmentioning

confidence: 99%

Covered metal stent for tumor obstruction of efferent loop recurrence after gastrectomy

Cheung

Chung

1997

Surg Endosc

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“…plastic stent placement led to higher complication rates. In a retrospective review, Buset et al [54] compared 116 patients treated by stenting with 28 treated by laser. The stented patients suffered higher compli cations (13.8 vs. 4.3%), but technical success and relief of dysphagia were not different between the two treatment regimens.…”

Section: Gianiurco Stentmentioning

confidence: 99%

Endoscopic Palliation for Esophageal Cancer

Lee

Lieberman

1997

Dig Dis

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Endoscopic esophageal dilation, laser therapy, and plastic and metal stent placement provide effective palliation of dysphagia in most patients with esophageal cancer. Because the techniques and indication are still being refined, the choice of endoscopic palliation should be based on patient-specific factors such as location and character of the tumor and more importantly on the availability of physician expertise.

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Palliative endoscopic management of obstructive esophagogastric cancer: laser or prosthesis?

Cited by 76 publications

References 12 publications

Use of Laser in the Relief of Malignant Dysphagia: A District Hospital Experience

Use of Laser in the Relief of Malignant Dysphagia: A District Hospital Experience

Covered metal stent for tumor obstruction of efferent loop recurrence after gastrectomy

Endoscopic Palliation for Esophageal Cancer

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