Recanalization of tube overgrowth: a useful new indication for laser in palliation of malignant dysphagia

I. R. Sargeant, L. A. Loizou, M. Tulloch, S. Thorpe, S. G. Bown

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Overgrowth of an esophageal prosthesis by cancer is a late complication of insertion which presents a difficult management problem. We have treated 14 such patients; 9 had Celestin tubes and 5 Atkinson tubes in situ for a median of 7 months. The median patient age was 75 years; 3 had squamous cell carcinomas and 11 adenocarcinomas; 12 were at the lowest thoracic esophagus or cardia, and 2 were anastomotic. Eleven tubes were overgrown at the top, two at the bottom only, and one at both ends. Dysphagia was graded from 0 to 4 (0 = normal; 4 = dysphagia for liquids). All patients but one improved with treatment. The median pre-treatment grade was 4 (range, 2 to 4) and post-treatment was 2 (0 to 3). This improvement was significant (p < 0.01 Wilcoxon-signed rank). Most patients required only one or two endoscopies. The median survival was 9 weeks from first laser session (range, 3 to 36 weeks). We feel these results justify laser treatment in most patients in whom cancer overgrowth causes blockage of an esophageal prosthesis. (Gastrointest Endosc 1992;38:165-169).

Original languageEnglish
Pages (from-to)165-169
Number of pages5
JournalGastrointestinal Endoscopy
Volume38
Issue number2
DOIs
Publication statusPublished - 1992

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