The use of ethanol injection under endoscopic control to palliate dysphagia caused by esophagogastric cancer.

Nine patients with dysphagia caused by unresectable tumors of the esophagus and cardia (eight with squamous-cell carcinomas and one with adenocarcinoma) were treated with absolute (95 g/l) alcohol mixed with 0.5% methylene blue. Total volumes ranging from 16 to 41 ml were injected endoscopically during sessions separated at 5-day intervals. The results were evaluated by endoscopic and radiological follow-up, as well as clinically, according to Bown's dysphagia score. Treatment had to be stopped in one patient with a preexisting esophagobronchial fistula. In the remaining eight patients, the mean dysphagia score decreased from 3.4 before treatment to 1.2 after treatment. After treatment, all patients were able to swallow a solid or semisolid diet. Treatment was repeated when dysphagia recurred, with a mean interval of 31.5 days between treatments. No complications were encountered. In our view, the preliminary results using this simple and inexpensive technique warrant comparative trials with other methods of palliation.