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. 1992 Dec;33(12):1602–1607. doi: 10.1136/gut.33.12.1602

Endoscopic palliation for inoperable malignant dysphagia: long term follow up.

V Maunoury 1, J M Brunetaud 1, D Cochelard 1, B Boniface 1, A Cortot 1, J C Paris 1
PMCID: PMC1379568  PMID: 1283144

Abstract

This prospective non-randomised trial of 128 selected patients with unresectable oesophageal or gastrooesophageal junction cancers aims to evaluate the initial relief of malignant obstruction by means of bipolar electrocoagulation for both circumferential and submucosal strictures of Nd:YAG laser for the other patients. A limited dilatation was performed initially if a small calibre endoscope was unable to pass through the stricture. Prompt and significant relief of dysphagia without complications was achieved in 83% of patients. Improved patients were retreated monthly during the follow up period. Radiotherapy was recommended when possible. Symptomatic relief of obstruction lasted 4.2 months on average and 76% of patients remained palliated until death. Monthly retreatment using the most appropriate endoscopic procedure for the tumour configuration and radiotherapy after endoscopic relief of obstruction seems to give the best palliation for patients with unresectable cancers of the oesophagus or gastrooesophageal junction.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Akiyama H., Tsurumaru M., Watanabe G., Ono Y., Udagawa H., Suzuki M. Development of surgery for carcinoma of the esophagus. Am J Surg. 1984 Jan;147(1):9–16. doi: 10.1016/0002-9610(84)90027-8. [DOI] [PubMed] [Google Scholar]
  2. Barr H., Krasner N., Raouf A., Walker R. J. Prospective randomised trial of laser therapy only and laser therapy followed by endoscopic intubation for the palliation of malignant dysphagia. Gut. 1990 Mar;31(3):252–258. doi: 10.1136/gut.31.3.252. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Bizer L. S. Adenocarcinoma of the stomach: current results of treatment. Cancer. 1983 Feb 15;51(4):743–745. doi: 10.1002/1097-0142(19830215)51:4<743::aid-cncr2820510432>3.0.co;2-b. [DOI] [PubMed] [Google Scholar]
  4. Bown S. G., Hawes R., Matthewson K., Swain C. P., Barr H., Boulos P. B., Clark C. G. Endoscopic laser palliation for advanced malignant dysphagia. Gut. 1987 Jul;28(7):799–807. doi: 10.1136/gut.28.7.799. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Bown S. G. Palliation of malignant dysphagia: surgery, radiotherapy, laser, intubation alone or in combination? Gut. 1991 Aug;32(8):841–844. doi: 10.1136/gut.32.8.841. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Earlam R., Cunha-Melo J. R. Oesophageal squamous cell carcinoma: I. A critical review of surgery. Br J Surg. 1980 Jun;67(6):381–390. doi: 10.1002/bjs.1800670602. [DOI] [PubMed] [Google Scholar]
  7. Fleischer D. A comparison of endoscopic laser therapy and BICAP tumor probe therapy for esophageal cancer. Am J Gastroenterol. 1987 Jul;82(7):608–612. [PubMed] [Google Scholar]
  8. Fleischer D., Sivak M. V., Jr Endoscopic Nd:YAG laser therapy as palliation for esophagogastric cancer. Parameters affecting initial outcome. Gastroenterology. 1985 Oct;89(4):827–831. doi: 10.1016/0016-5085(85)90579-7. [DOI] [PubMed] [Google Scholar]
  9. Graham D. Y., Tabibian N., Schwartz J. T., Smith J. L. Evaluation of the effectiveness of through-the-scope balloons as dilators of benign and malignant gastrointestinal strictures. Gastrointest Endosc. 1987 Dec;33(6):432–435. doi: 10.1016/s0016-5107(87)71681-2. [DOI] [PubMed] [Google Scholar]
  10. Jensen D. M., Machicado G., Randall G., Tung L. A., English-Zych S. Comparison of low-power YAG laser and BICAP tumor probe for palliation of esophageal cancer strictures. Gastroenterology. 1988 Jun;94(6):1263–1270. doi: 10.1016/0016-5085(88)90662-2. [DOI] [PubMed] [Google Scholar]
  11. Jensen D. M. Palliation of esophagogastric cancer via endoscopy. Gastroenterol Clin Biol. 1987 May;11(5):361–363. [PubMed] [Google Scholar]
  12. Johnston J. H., Fleischer D., Petrini J., Nord H. J. Palliative bipolar electrocoagulation therapy of obstructing esophageal cancer. Gastrointest Endosc. 1987 Oct;33(5):349–353. doi: 10.1016/s0016-5107(87)71636-8. [DOI] [PubMed] [Google Scholar]
  13. Krasner N., Barr H., Skidmore C., Morris A. I. Palliative laser therapy for malignant dysphagia. Gut. 1987 Jul;28(7):792–798. doi: 10.1136/gut.28.7.792. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Laine L. Determination of the optimal technique for bipolar electrocoagulation treatment. An experimental evaluation of the BICAP and Gold probes. Gastroenterology. 1991 Jan;100(1):107–112. doi: 10.1016/0016-5085(91)90589-d. [DOI] [PubMed] [Google Scholar]
  15. Lightdale C. J., Zimbalist E., Winawer S. J. Outpatient management of esophageal cancer with endoscopic Nd:YAG laser. Am J Gastroenterol. 1987 Jan;82(1):46–50. [PubMed] [Google Scholar]
  16. Maunoury V., Brunetaud J. M., Cochelard D., Delette O., Cortot A., Paris J. C. Traitement palliatif des cancers de l'oesophage et du cardia par photoablation laser. Gastroenterol Clin Biol. 1987 May;11(5):371–375. [PubMed] [Google Scholar]
  17. Mellow M. H., Pinkas H. Endoscopic laser therapy for malignancies affecting the esophagus and gastroesophageal junction. Analysis of technical and functional efficacy. Arch Intern Med. 1985 Aug;145(8):1443–1446. [PubMed] [Google Scholar]
  18. Naveau S., Chiesa A., Poynard T., Chaput J. C. Endoscopic Nd-YAG laser therapy as palliative treatment for esophageal and cardial cancer. Parameters affecting long-term outcome. Dig Dis Sci. 1990 Mar;35(3):294–301. doi: 10.1007/BF01537405. [DOI] [PubMed] [Google Scholar]
  19. Rutgeerts P., Vantrappen G., Broeckaert L., Muls M., Geboes K., Coremans G., Janssens J. Palliative Nd:YAG laser therapy for cancer of the esophagus and gastroesophageal junction: impact on the quality of remaining life. Gastrointest Endosc. 1988 Mar-Apr;34(2):87–90. doi: 10.1016/s0016-5107(88)71269-9. [DOI] [PubMed] [Google Scholar]
  20. Schulze S., Fischerman K. Palliation of oesophagogastric neoplasms with Nd:YAG laser treatment. Scand J Gastroenterol. 1990 Oct;25(10):1024–1027. doi: 10.3109/00365529008997629. [DOI] [PubMed] [Google Scholar]

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