[Esophageal endoprosthesis in advanced carcinoma. Personal experiences with the endoscopically inserted Häring tube]

The majority of esophageal carcinomas and cancers obstructing the cardia is still beyond surgical cure, and the need for effective palliative therapy is as great as ever. Among the various endoscopic techniques currently available, we prefer inserting prosthetic esophageal tubes and laser therapy. Here, we report our experience with 61 placements of prosthetic tubes in 58 patients. The insertion of the tube was always performed after successful dilatation of the stenosis under intravenous sedation and analgesia. The indications included carcinomas of the esophagus and the cardia, as well as neoplastic strictures after surgery. In seven patients, an additional esophageal-bronchial fistula was present. The median survival was 14 weeks (range: 1 to 60 weeks). 18 patients lived for more than 16 weeks. Six patients died from severe complications due to the endoscopic procedure, 13 patients had minor complications which were treated conservatively. In summary, endoscopic intubation is simple and effective as a palliative treatment for malignant esophageal obstruction. The relative value of intubation compared to laser therapy is not known yet and remains to be determined.