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Palliation of dysphagia
1Department of Cardiothoracic Surgery, Cook County Hospital, Chicago, Illinois, USA.
Chest Surgery Clinics of North America
|September 1, 2000
Summary
This article reviews non-surgical treatments for esophageal carcinoma, including stenting, photodynamic therapy, cryoablation, and bipolar cautery probe options. It details methods, complications, and clinical applications for these esophageal cancer interventions.
Area of Science:
- Oncology
- Gastroenterology
- Interventional Endoscopy
Background:
- Esophageal carcinoma presents significant treatment challenges.
- Surgical resection is a primary option but not always feasible or preferred.
- Minimally invasive interventions are crucial for managing esophageal cancer.
Purpose of the Study:
- To review non-surgical interventional options for esophageal carcinoma.
- To discuss the techniques, complications, and clinical utility of various endoscopic therapies.
- To compare the advantages and disadvantages of different palliative and therapeutic approaches.
Main Methods:
- Discussion of diagnostic methods for esophageal cancer.
- Detailed explanation of plastic and self-expanding metal stent insertion techniques.
- Overview of neodymium:yttrium-aluminum-garnet photodynamic therapy, cryoablation, and BICAP (bipolar cautery probe) procedures.
Main Results:
- Stent insertion offers palliation for obstruction and dysphagia.
- Photodynamic therapy, cryoablation, and BICAP provide localized tumor control.
- Each method has specific complication profiles and indications.
- Clinical scenarios highlight the practical application of these interventions.
Conclusions:
- Non-surgical interventions are vital for esophageal carcinoma management.
- Stenting, PDT, cryoablation, and BICAP offer valuable alternatives to surgery.
- Careful patient selection and technique are key to successful outcomes and minimizing complications.