Cusumano A, Ruol A, Segalin A, Norberto L, Baessato M, Tiso E, Peracchia A
First Department of Surgery, University of Padua, Italy.
Ann Thorac Surg. 1992 Jun;53(6):1010-4. doi: 10.1016/0003-4975(92)90376-f.
Between 1980 and 1989, 355 patients with cancer of the esophagus and 54 with cancer of the cardia underwent push-through intubation because of advanced tumor stage or medical contraindications to tumor resection. In 36 other patients (8.1%), the attempt at transtumoral intubation failed. The hospital mortality rate after intubation was 3.4%. The following complications were observed: hemorrhage in 2.0% of the patients, esophageal perforation in 4.9%, tube dislodgment in 12.7%, and tube obstruction in 4.4%. Early resumption of semisolid oral feeding was possible in 80% of the discharged patients. The actuarial 1-year survival rate was 7.7% and the median survival, 3.9 months. In conclusion, push-through intubation represents a valid therapeutic choice, which is indicated mainly for patients with a long, infiltrating, and circumferential stricture of the thoracic esophagus or cardia that is inoperable and for patients with an esophagorespiratory or esophagomediastinal fistula.
1980年至1989年间，355例食管癌患者和54例贲门癌患者因肿瘤分期较晚或存在肿瘤切除的医学禁忌证而接受了置入式插管。在另外36例患者（8.1%）中，经肿瘤置入插管的尝试失败。插管后的医院死亡率为3.4%。观察到以下并发症：2.0%的患者出现出血，4.9%的患者发生食管穿孔，12.7%的患者出现导管移位，4.4%的患者出现导管阻塞。80%的出院患者能够早期恢复半固体口服喂养。精算1年生存率为7.7%，中位生存期为3.9个月。总之，置入式插管是一种有效的治疗选择，主要适用于胸段食管或贲门存在长段、浸润性和环形狭窄且无法手术的患者，以及患有食管气管瘘或食管纵隔瘘的患者。
