[By-pass surgery with infusion therapy for non-resectable esophageal cancer]

In principle, the following three steps are considered for by-pass surgery; I. A gastric tube is moved up to the retro-sternal or to the ante-thoracic position. A T-tube is the inserted in the mid position of the gastric tube for decompression and drainage. 2. A retention vinyl tube is inserted in to the excluded esophagus for the purpose of post infusion therapy and for evaluation of the therapy. 3. A Roux-Y anastomotic internal fistula is placed at the distal site of the excluded esophagus. As a plan for combined therapy, PANa-Oil bleomycin (oil bleomycin 30 mg, PANa 0.5 g) is the infused into the isolated esophagus after the by-pass operation and the clinical effect is evaluated by introducing a radiopaque medium into the excluded esophagus via an inserted vinyl tube. Such infusion therapy after by-pass surgery was given to 3 patients and in 1 patient it was very effective. This suggested a positive effect on survival in cases of non-resectable esophageal cancer without side effects.