[Esophageal prosthesis].

Abstract

The patient with advanced esophageal cancer (AEC) is condemned to a short existence. The management of the majority of these patients is only palliative. The results obtained with surgery, radiotherapy and chemotherapy are only slightly encouraging. The patients require a highly effective palliative treatment that resolves the dysphagia, and the endoscopic procedures have demonstrated their high effectiveness. The principal objective is to better the quality of the life of the patient. Advantages of the Endoscopic Procedure (EP): this is carried out in only one session, does not require hospitalization, is low in cost, resolves the dysphagia, is well tolerated, the morbidity-mortality is low, and it is useful in esophagobronchial fistulas. Disadvantages: greater morbidity, is not useful in cervical esophagus, fluoroscopy is indispensable, it requires skill and experience, and the prosthesis can migrate. We report here on the insertion of 31 non-expandable polyvinyl EPs in patients with (AEC) (15.7% of 197 cases of(AEC) diagnosed in 4 years 5 months); 21 males (67.74%) and 10 females (32.25%); the average extension of the obstructed segment was 6.06 cm, and was localized in 77.41% in the inferior third; 64.51% were adenocarcinomas, and 32.25% were epidermoid carcinoma; five carcinomas (16.1%) originated in the Barrett esophagus; the complications were the following: migration 3 (9.67%), perforation 2 (6.45%), and obstruction by food 1 (3.22%). The dysphagia was resolved in all of the patients.