[Perforation of esophageal cancer (author's transl)]

Perforation of an esophageal cancer can occur spontaneously or during radiotherapy. If the perforation is the first manifestation of the cancer, the diagnosis depends on X-ray and endoscopy. During radiotherapy, the intending perforation must be carefully watched for. We have treated two perforations appearing as first manifestation of the cancer and 3 developed during evolution, 2 of them during radiotherapy. Various treatments have been applied. In 2 cases, resection was possible, curative in one, palliative in the other. In the other 3 cases, retrosternal by-pass has allowed feeding and radiotherapy. Such a complication generally condemns the patient to a gastrostomy. However, a more aggressive surgical attitude can be adopted if the general status of the patient permits. An esophageal endo-prosthesis can also be used.