Pulsion intubation for palliation of carcinoma of the oesophagus

Hegarty, M. M.; Angorn, I. B.; Bryer, J V; Henderson, B J; Roux, B. T. Le; Logan, Andrew

doi:10.1002/bjs.1800640304

Cited by 32 publications

(13 citation statements)

References 14 publications

(16 reference statements)

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“…The mean survival time for the 15 patients malignant stricture in the esophagus or car& were intu-who survived the Postoperative period ranged between bated with a Celestin tube [Celestin, 19591. All tumors 27 and 291 days (mean 125 days). were considered unresectable either because of tumor All complications are presented in [Palva et al, 1974;Hegarty et al, 1977;Lishman et al, 1980;Watson, 19821. The complication rate is considered higher after surgical than after endoscopic intubation.…”

Section: Resultsmentioning

confidence: 99%

“…Intubation of the esophagus is considered by most patients the most acceptable method for palliation. In many studies [Das and John, 1973;Sanfelippo and Bernatz, 1973;Girardet et al 1974;Thomas, 1974, Hegarty et al, 1977Atkinson et al, 1978;Gallagher et al, 1978;Den Hartog Jager et al, 1979, Saunders, 1979Watson, 19821 the improved quality of life after intubation of the esophagus has been documented. We could in this study report on relief of dysphagia in two-thirds of our patients, which is in agreement with previous studies.…”

Section: Discussionmentioning

confidence: 99%

“…At the time of the tumor was located in the lower esophagus Or palliation is to give relief of dysphagia and to make achieved by a gastrostomy but most patients find this cording to Visick [Watson, 19821: 1) no dysphagia; 2) solution less acceptable. Many investigations have also dysphagia for solids; 3) dysphagia for semisolids; and 4) shown good palliation of dysphagia by esophageal intu-dysphagia for liquids-patients had dysphagia Of bation [Das and John, 1973;Sanfelippo and Bernatz, patients 1973;Girardet et al, 1974;Thomas, 1974;Hegarty et al, 1977;Atkinson et al, 1978;Gallagher et al, 1978; Den intubations were performed under general anes-H~~~~ J~~~~ et al, 1979;Saunders, 19791. ~~~l i~~ we thesia.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Permanent indwelling celestin tubes in malignant esophageal strictures

Lindholmer

Samuelsson

Theve

1984

Journal of Surgical Oncology

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Permanent indwelling celestin tubes in malignant esophageal strictures

Lindholmer

Samuelsson

Theve

1984

Journal of Surgical Oncology

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“…gr0ups3,S-8, [10][11][12][13][14]16,[20][21][22][23][24][25][26][27][28][29] ments (surgery, radiation therapy, and chemotherapy, used alone or in combination) have failed. Of the 12 main factors evaluated in our study, only two appear to have prognostic significance: patients with stenosis less than 7 mm, and patients with stenosis located at the lower third and cardia.…”

Section: Discussionmentioning

confidence: 99%

Esophageal prothesis for neoplastic stenosis. A prognostic study of 77 cases

Chavy

Rougier

Pieddeloup

et al. 1986

Cancer

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Esophageal prothesis (EP) is a palliative treatment for inoperable neoplastic stenosis. Ninety-one patients were candidates for EP placement between 1978 and 1983. EP placement was successful in 77 patients. Of these: 85% had primary esophageal cancer; 15% had bronchial or mediastinal carcinoma; 83% had stenosis in the middle third. Dysphagia was the main symptom in 84%, and tracheoesophageal fistulae in 16%. The observed median survival was 3.2 months +/- 1.9 (2 standard deviations [SD]), and the survival rate at 1 year was 7%. With the single-factor analysis method, not one of 12 factors presented any significance (age, sex, general status, anterior treatment, lesion site, endoscopic feature, stenosis diameter, histologic features, metastasis, tracheal involvement, symptoms, and type of prothesis). Two factors had a P value approaching significance: there were slightly longer survival rates in patients with a stenosis diameter less than 7 mm (P less than 0.07), and with stenosis located in the lower third and cardia (P less than 0.07). By multivariate analysis (Cox model), prognostic significance was found in only one factor: the location in the lower third and cardia (P = 0.002, relative risk = 3). The quality of life after EP placement was briefly improved: 80% of 73 evaluable patients had improvement in dysphagia for a mean duration of 3.7 months +/- 2 (2 SD), especially patients with a good general status (0 and 1; P less than 0.01); and 45% of patients had improvement of their general status for a mean duration of 4.1 months +/- 2 (2 SD). Minor complications related to EP placement were observed in 40% of patients (pain, obstruction, and mobilization), and severe complications were observed in 20% (perforation, 11 cases; fistulae, 5 cases, with death in 3 cases; hemorrhages, 4 cases). In conclusion, EP is a good palliative treatment, although complications are frequent, and evaluation of patient comfort is required to compare this procedure with other available techniques.

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“…The Negus oesophagoscope was then passed for visualisation and biopsy of the stricture (benign strictures of the oesophagus were excluded from the study). Antegrade dilatation of the stricture and intubation with the modified Proctor-Livingstone tube (Latex Products, Johannesburg) was carried out as described by Hegarty et al 8 Aspiration of acid onto litmus paper via a nasogastric tube confirmed correct placement of the endooesophageal prosthesis and free passage into the stomach. Repeat dilatation was attempted after three days if the first attempt had to be abandoned.…”

Section: Methodsmentioning

confidence: 99%

Carcinoma of the oesophagus in Transkei: treatment by intubation.

Cotton¹,

Sammon²

1989

Thorax

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The management of carcinoma of the oesophagus poses formidable logistic problems in countries such as Transkei where the condition is common and resources are limited. Most patients present late, often with complications, and are reluctant to undergo major surgery. Two hundred and fifty consecutive patients who presented over nine months in Transkei were studied. The incidence increased with age until 70 years and the disease occurred equally in men and women. The neoplasm was predominantly squamous cell (243 patients, 97%) and was found most often in the middle third ofthe oesophagus (1 18, 47%). On admission only eight ofthe 250 patients could take a semi-solid diet and only 21 a fluid diet. The policy where feasible was to introduce a Proctor Livingstone tube endoscopically through the dilated oesophageal stricture by a pulsion technique under light general anaesthesia. When abdominal perforation ofthe oesophagus seemed likely, retrograde intubation via a gastrotomy was performed. Sixty patients were not intubated, because the stricture was too proximal (47) or could not be dilated adequately (6), the lesion was suitable for resection (6), or the patient refused (1). Fifty one (27%) patients died in hospital, 29 deaths being due to oesophageal perforation (including six of the 10 who were intubated retrogradely). The mean hospital stay was 4 7 days. On discharge 64% ofthe intubated patients were able to take semi-solid food and a further 6% a fluid diet. Palliation by intubation was performed rapidly and the tube was well tolerated by patients. The overall mortality was high, but this can be reduced by experience. Intubation is an acceptable, cost effective solution where large numbers ofpatients present with advanced oesophageal carcinoma in circumstances where resources are severely limited.

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Pulsion intubation for palliation of carcinoma of the oesophagus

Cited by 32 publications

References 14 publications

Permanent indwelling celestin tubes in malignant esophageal strictures

Permanent indwelling celestin tubes in malignant esophageal strictures

Esophageal prothesis for neoplastic stenosis. A prognostic study of 77 cases

Carcinoma of the oesophagus in Transkei: treatment by intubation.

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