Palliative prosthetic intubation in gastric cancer

Obstruction to swallowing from recurrent gastric cancer following total gastrectomy or when the tumor is initially unresectable presents a major surgical challenge. Resection of the recurrence or various bypass procedures are indicated, when technically feasible, unless widespread metastases are found. A useful palliative approach for obstructed patients with a limited prognosis is the use of a Celestin endoesophageal tube. This report describes the indications for and method of insertion in two typical clinical situations. Anchoring the tube to the anterior abdominal wall prevents proximal migration of the prosthesis, a complication which occurred six months later in a patient in whom this was not possible.