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[Palliative treatment of esophageal cancer with transendoscopic injection of alcohol]
A Güitrón1, R Adalid, F Huerta
1Departamento de Endoscopia Digestiva, Hospital de Especialidades Núm. 71. Centro Médico Nacional Torreón, Instituto Mexicano del Seguro Social.
Background:
Few patients who present with dysphagia from esophageal cancer are curable. The rates of surgical resecability are low and the reported 5-yr survival rates are < 10%. Nonsurgical, endoscopic palliation of obstructing gastrointestinal cancers has became popular with stents, Nd: YAG laser, BICAP tumor probe, self-expanding metallic stents. Because of limited availability and extraordinary cost of equipment, most gastrointestinal endoscopy units can't afford their acquisition. Endoscopic injections of ethanol are useful for palliation of malignant dysphagia.
Aims:
To examine if injections of ethanol are useful, in our patients, for palliation of malignant dysphagia.
Patients, Method And Results:
Six male patients with dysphagia caused by inoperable or unresecable esophageal cancer were treated by endoscopic injection of ethanol to induce tumor necrosis. Prior to treatment, patients had a mean dysphagia grade of 3.6. After treatment, an optimum dysphagia grade (mean 0.8) was achieved with a mean of 6 injections treatments. There were no complications associated with endoscopic injection of ethanol. Mean patient survival rate was 286 days (range: 36-973).
Conclusions:
These results suggest that injections of ethanol to induce tumor necrosis have considerable potential for palliation of malignant dysphagia in patients with exophytic neoplasm.