Endoscopic palliative treatment of esophageal and cardial cancer: a new antireflux prosthesis. A study of 40 cases.

Forty patients with malignant cardioesophageal obstruction were treated by fiberoptic intubation. Their ages ranged from 38 to 84 years. Eight patients had bronchoesophageal fistula, 9 had tumor relapse after radiation therapy, and 5 had hiatal hernia. In 7 with severe or total stenosis, diathermic resection was used with no morbidity or mortality. Complications were hemorrhage, 2; regurgitation, 2; atelectasis, 1; tube migration, 1; and bronchoesophageal fistula, 1, for a total of 17.5%. The procedure mortality was 2.5%. Actual survival time after intubation was 37.5% at 12 months. It was demonstrated that a new antireflux prosthesis, designed for endoscopic insertion, diminished morbidity and avoids mortality due to regurgitation; we would therefore recommend to be used in patients not otherwise amenable to surgery or radiotherapy, with cancer of the cardia, lower esophagus or lesions beyond 24 mm from the incisors associated with hiatal hernia.