Study on Bypass Operation and Esophageal Prosthesis as Palliation for Unresectable Esophageal Cancer

Osamu Konno, Shin Koyama, Michihiko Kogure, Shinya Terashima, Yoshiharu Haga, Koumei Sagawa, Yoshihiro Sato, Hitoshi Inoue, Ryoichi Motoki

First Department of Surgery, Fukushima Medical College

A comparison of the diet intake state and survival period between patients receiving a bypass operation (group A; n=11) and esophageal prosthesis intubation (group B; n=8) for esophageal cancer was made and the usefulness of an esophageal prosthesis was investigated. The results were as follows, 1) In group A, 10 cases were highly advanced and the mean age was 65. In group B, 3 patients were intubated during the operation, 5 cases (2 with esophago-bronchial fistula) were diagnosed as A₃ by preoperative examination and the mean age was 61. 2) Oral intake was possible in only 2 patients in group A, and intake of a regular diet or rice gruel was possible from several days after intubation in all patients in group B. 3) In group A, all except 1 patient could not be discharged because of nutritional management or postoperative complication and died in the hospital. The mean postoperative survival period was 62±74 days. In group B, 6 patients were dischaged from the hospital and 2 could resume work. The mean survival period was 118±57 days for 7 patients excluding 1 survivor, and the survival period was significantly longer than that in group A (p<0.05). Hematemsis and hemoptysis was observed as the cause of death, in 4 cases. 4) Intubation was performed at one time using an endoscope in all patients including those with a pinhole lumen. Complications such as bleeding and perforation were not observed. We conclude that esophageal intubation is useful for cases of unresectable esophageal cancer.

Key words
unresectable esophageal cancer, by-pass operation for esophageal cancer, esophageal prosthesis intubation, palliative treatment of esophageal cancer

Reprint requests
Osamu Konno First Department of Surgery, Fukushima Medical College
1 Hikarigaoka, Fukushima, 960-12 JAPAN

Accepted
January 16, 1991

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