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The Annals of Thoracic Surgery, Vol 53, 1010-1014, Copyright © 1992 by The Society of Thoracic Surgeons

ARTICLES

Push-through intubation: effective palliation in 409 patients with cancer of the esophagus and cardia

A Cusumano, A Ruol, A Segalin, L Norberto, M Baessato, E Tiso and A Peracchia
First Department of Surgery, University of Padua, Italy.

Between 1980 and 1989, 355 patients with cancer of the esophagus and 54 with cancer of the cardia underwent push-through intubation because of advanced tumor stage or medical contraindications to tumor resection. In 36 other patients (8.1%), the attempt at transtumoral intubation failed. The hospital mortality rate after intubation was 3.4%. The following complications were observed: hemorrhage in 2.0% of the patients, esophageal perforation in 4.9%, tube dislodgment in 12.7%, and tube obstruction in 4.4%. Early resumption of semisolid oral feeding was possible in 80% of the discharged patients. The actuarial 1- year survival rate was 7.7% and the median survival, 3.9 months. In conclusion, push-through intubation represents a valid therapeutic choice, which is indicated mainly for patients with a long, infiltrating, and circumferential stricture of the thoracic esophagus or cardia that is inoperable and for patients with an esophagorespiratory or esophagomediastinal fistula.

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