[Esophageal endoprosthesis by laparo-gastroscopy with transtumoral approach in advanced esophageal and esophagogastric cancer].

INTRODUCTION

Romania is part of the countries with low incidence of esophagus cancer (the mortality rate M/W at 100,000 peoples being 1.6/0.3), but the diagnosis of the disease, is most frequently incidental in stages that make any intention of radical treatment a desideratum frequently unattainable.

MATERIAL AND METHOD

In the impossibillity of curative treatment we realised laparoscopic procedure of esophageal prosthesis (through traction not through pushing as in endoscopic procedures) at 60 patients with esophageal and esogastric cancer in advanced stages (distance metastasis, almost non-existing lumen, emaciation, severe decline of general state). The originality of the laparogastroscopic method has been international recognized.

RESULTS AND DISCUSSIONS

This minimally invasive prosthetic original method presumes minimal agression, gastroscopic approach, the insertion of the prosthesis is made through traction not through pushing (transtumoral drilling, compresive and styptic insertion, etc.). The patient can eat at 8-12 hours after operation and the contact with the hospital is shorter, the hospitalization period was between 3 and 7 days. We had survivals between 5 months and 4 years.

CONCLUSION

The method that we propose is simple and efficient is a solution for repairing the endoscopic failure, is an alternative for the crippling gastrostomy, or, for the cases when the preoperative most optimistic estimations might comply a sick person and unbalanced immunological, nutritional and psychological, to an intervention to vast in scope (anaesthetic and surgical), compared to the final solution, palliative, in fact.