Advanced Esophageal Cancer Palliative Surgical Therapy Using Isoperistaltic Gastric Tube

Abstract

Although malignant neoplasms of the esophagus remain a very common disease, their diagnosis might often come late, which explains why 50% of patients require palliative treatment. The ideal scenario would be the performance of procedures that provided an adequate quality of life and satisfactorily restored swallowing. This chapter aims to describe the results of palliative methods, discussed with emphasis on the technique of the isoperistaltic greater curvature gastric tube (IGCGT). About 143 patients with unresectable squamous cell carcinoma of the esophagus (T4b) were evaluated at this facility. In the early postoperative evaluation, 64 patients (44.7%) presented systemic complications, with pulmonary infection being the most frequent; 51 patients (35.6%) presented local complications, with cervical esophagogastric anastomosis leak being the most frequent. Thirteen patients (9.1%) died as a result of postoperative complications. Out of 112 patients who were adequately followed up, 91 (81.2%) achieved good palliation with this procedure, as they had adequate restoration of swallowing function, with a median survival of 3 years in 63 patients (69.2%). With these results, it is possible to conclude that despite showing non-negligible morbidity, IGCGT can be performed quickly and safely, offering adequate palliation and survival rate.