Palliative intubation of malignant esophagogastric obstruction

Our experience with endoprosthesis placement in 400 patients with obstructing esophagogastric or pulmonary malignancy includes patients with bronchoesophageal fistulas, carcinoma of the cardia, tumor recurrence after Billroth I and Billroth II surgery, tumor recurrence after proximal and total gastric resection, and patients with total involvement of the stomach. We employed an introducer and tubes that were designed and adapted to solve specific problems of dilatation and intubation. Adequate tube functioning was obtained in 95% of the patients, despite the fact that we treated some who had been previously considered to be unsuitable candidates. Complications were severe bleeding (1%), perforation (7%), early migration (15%), late migration (8%), obstruction (6%), and pressure necrosis (3%). The mortality rate due to the procedure was 4%. In general, marked improvement of the quality of life was obtained. Mean survival time was 113 days.