Palliative push-through intubation for malignant obstruction of the gastroesophageal junction

Methods available for palliative intubation of the gastroesophageal junction for malignant obstruction are discussed. In a previous report from this unit, we noted that the push-through method with a Souttar tube is superior in many respect to the pull-through method with the Mousseau-Barbin tube in cases of esophageal carcinoma. However, a push-through method at the cardia, although highly desirable, had not yet been employed because of safety reasons. This paper describes a technique to overcome the dangers of push-through intubation at the gastroesophageal junction and reports its successful use in 16 patients.