HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Donald E. Low Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Low, D. E. Search for Related Content PubMed PubMed Citation Articles by Low, D. E. Related Collections Related Article

Ann Thorac Surg 1996;62:961-962
© 1996 The Society of Thoracic Surgeons

---

Editorials

Keeping an Open Mind While Restoring Esophageal Patency in Patients With Cancer and Esophagorespiratory Fistula

Virginia Mason Medical Center, Seattle, Washington

The first 20% of the full text of this article appears below.

Successful management of patients with malignant, incurable esophageal obstruction should be safe and effective treatment that is both time and cost efficient. Radiation, both external beam and brachytherapy, and chemotherapy are options that may be applicable after the relief of the acute obstructive process. However, the prerequisite delay in the resumption of oral nutrition and the ability to manage salivary secretions requires techniques that produce immediate results.

Repeated bouginage can provide immediate improvement in swallowing but usually requires frequent repeat treatments. Laser therapy has a proven track record with respect to acute palliation of malignant obstruction but requires expensive equipment and multiple treatments with both complication rates and outcomes highly dependent on the skill and experience of the laser endoscopist. As a result, the vast majority of people with malignant esophageal obstruction are currently managed with a variety of endoscopic and fluoroscopically inserted esophageal prostheses.

See also 963.

The history of esophageal stenting originates with the surgically placed stents such as the Celestin tube. These stents now see limited application due to the development of nonoperatively placed stents and unacceptably high in-hospital mortality rates [1]. Conventional pulsion stents such as the Atkinson tube (Key Med, Inc, New Hyde Park, NY) and the coiled polyvinyl prosthesis (Wilson-Cook, Inc, Winston-Salem, NC) have seen wide application, and successful palliation has been achieved in more than 90% of cases in some series [2]. However, complications including bleeding, tracheal compression, prosthesis occlusion, and migration in up to 50% of cases [3], and perforation and procedure-related mortality . . . [Full Text of this Article]

Related Article

Treatment of Esophageal Obstruction With Covered, Self-Expanding Esophageal Wallstents

Darroch W. O. Moores and Riivo Ilves
Ann. Thorac. Surg. 1996 62: 963-967. [Abstract] [Full Text]

This article has been cited by other articles:

				M. De Groot, D. W. O. Moores, and R. Ilves Expandable Stents in Esophageal Malignancy Ann. Thorac. Surg., July 1, 1997; 64(1): 287 - 288. [Full Text]