Fibre-endoscopic insertion of oesophageal tube for palliation in malignant oesophagogastric obstruction.

In 28 patients with malignant obstruction of the oesophagus or cardia, an intraluminal prosthesis was endoscopically inserted as palliation, to permit food intake. Of the 25 who survived the procedure, 23 were able to swallow satisfactorily and required no supporting parenteral nutrition. Complications arose in 13 patients (46%), however. Four of the tubes became obstructed and two were displaced during the follow-up period, and there were two cases of late massive bleeding from mucosal erosions. Perintubation perforation of the oesophagus occurred in two patients. One patient had immediate postintubation myocardial infarction, another had aspiration pneumonia and one had urinary retention. Following intubation, 19 patients could leave the hospital (76%) and 6 were transferred to long-stay units. The authors conclude that endoscopic insertion of an oesophageal prosthesis is a simple and quick procedure, involving less risk than conventional surgical measures for palliation in nonresectable malignant oesophagogastric obstruction. The relatively high incidence of minor complications is emphasized, though many may be prevented by accurate technique.