Incidence and management of laser-associated oesophageal perforation

✍ Scribed by M. R. Tyrrell; G. A. Trotter; A. Adam; Mr R. C. Mason

• Publisher: John Wiley and Sons
• Year: 1995
• Tongue: English
• Weight: 220 KB
• Volume: 82
• Category: Article
• ISSN: 0007-1323
• DOI: 10.1002/bjs.1800820933

✦ Synopsis

The incidence of oesophageal perforation in 350 patients undertaken before laser treatment (23 of 25 perforations). referred for laser treatment to palliate malignant Immediate recognition and the institution of an aggressive dysphagia is reported. Perforation occurred in 6 per cent non-operative management protocol resulted in survival in of patients or 2 per cent of treatment episodes. Perfor-20 of 23 patients. ation was usually due to oesophageal dilatation

The majority of patients who present with cancer of the oesophagus will either be unfit for resection or have advanced disease. Nevertheless, they require palliation of their dysphagia. Currently the two techniques most frequently used are intubation with an Atkinson tube or recanalization with the neodymium yttrium-aluminiumgarnet (NdYAG) laser. The major complication of these techniques is oesophageal perforation. In the case of intubation, the incidence of perforation varies between 8 and 11 per cent'-3. Reports on complications following laser treatment e x i ~t ~-~, but there is no comprehensive documentation regarding the risk of perforation or its management.

This retrospective review describes the incidence of oesophageal perforation in 350 consecutive patients referred for laser treatment of malignant dysphagia. It also details the results of non-operative management of these perforations.