[Particular aspects of endoprosthesis in malignant advanced pharingeal-esophageal stenosis]

The esophageal neoplasm is currently the seventh cause of death through cancer worlwide. In the developing countries it is situated on the fifth place and has one of the worst prognostics for a neoplasm. Due to the specifical intratoracical topography, clinically inaccesible and without symptoms, the disease is rather incurable when the disphagia appears.

The esophageal prosthesis procedure through laparogastroscopical approach, used by us, is an original one, noninvasive, acknowledged both nationally and internationally. The endoprosthesis esophageal cases belong to three Clinics of Surgery (Clinic Surgery 2 from Sibiu, Clinic Surgery 1 from Braila, Clinic of Surgery 4, Bucharest) on a period of 14 years (1996-2009), identically coordinated.

Out of the 68 patients, 18 cases have been cancers situated in the medial and inferior third and 28 have been eso-cardial-tuberositary neoplasms. In the cases of the high malignant pharingeal-esophageal stenosis, the placement of the prosthesis (different prosthesis adapted to this particular situation) in areas of aerial-digestive junction implies significant technical difficulties especially in the option with the conservation of the larinx as a fonatory and respiratory solution.

Our original procedure, simple and efficient presents numerous advantages which allow the widening of the indications of stent gastroenterology: firm traction, the possibility of catheterism through narrow lumens of 1-2 mm, sometimes anfractuous, the distal visibility, the visual placement or expanding of the prosthesis, the evaluation of the intraoperatory visceral or parietal methastasis and eventually the avoidance of the gastrostomic invalidation.