[Esophageal tumors at our outpatient clinic].

INTRODUCTION

In the 1984-1997 period 1179 tumorous patients presented themselves at the oesophagus consultation of the Ist. Department of Surgery of Semmelweis University. The authors examined the changes in the characteristic features of these patients and the task of supply.

OBJECT

The aim of analysis was estimating of the place and importance of the therapeutic methods applicable to ambulatory patients.

METHODS

Essential task of the outpatients service was to summarize the diagnostic results and to supply the lacks for the therapeutic plan of the patients. Having possession of the results they had to make decisions of the necessary and possible method of therapy. From the 1179 patients it was necessary the ward admittance of 787 patients, in 512 cases in hope of resective operation, and in 275 cases in order to carry out palliative intervention under hospitalized circumstances. 392 patients were treated as outpatients. To outpatients in 296 cases tube endoprosthesis was implanted by endoscopic method for palliative purposes, there were made 14 dilating nasogastric tube treatments, in 2 cases percutaneous endoscopic gastrostomy, and in the case of 116 patients there were collaborations in intraluminal after-loading irradiation treatments.

RESULTS

It appeared from the age-characteristics of the patients that the incidence in the examined period increased in the younger age-groups. The patients' main complaint was dysphagia, their average anamnesis-time was 4.03 months and it did not change during the 13 years. The incidence of the oesophago-respiratory fistula was 11.1% in the patient-population, and the incidence of reflectory dysphagia was 13.2%. There was an improvement in respect of the medical check-up of patients and the verification by histological examination of the tumorous process. In the case of 597 patients it was observed dysphagia requiring palliation and in 482 cases it succeeded to perform it by implanting endoprosthesis. There were 36 unsuccessful implantation attempts and in the case of 79 patients there were no conditions of intervention.

CONCLUSIONS

In the treatment of oesophageal tumorous patients the interventions made in favour of the palliative improvement of agglutination were executable within the frame of the outpatient service, from among of which the implantation of endoscopic tube appeared to be the method improving the patients' quality of life and survival with the best result. In the course of years palliative treatments were made more and more in the frame of outpatient service. The authors feel it necessary to consider all the condition-ameliorating treatment possibilities and applications, which may not be alternatives of each other but complementaries.