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Endoscopy 1997; 29(3): 155-159
DOI: 10.1055/s-2007-1004155
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

Nonsurgical Treatment of Esophageal Perforations After Endoscopic Palliation in Advanced Esophageal Cancer

T. Bisgaard, M. Wøjdemann, H. Heindorff, L. B. Svendsen
  • Dept. of Surgical Gastroenterology, Rigshospitalet, The National University Hospital, Copenhagen, Denmark
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Publication History

Publication Date:
17 March 2008 (online)

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Abstract

Background and Study Aims: Iatrogenic esophageal perforation during palliative endoscopic treatment in patients with incurable esophageal or cardiac cancer is a severe complication, associated with a high rate of mortality. The treatment remains controversial, since both nonsurgical and surgical treatment regimens are used. The present study describes a nonsurgical regimen.

Patients and Methods: Nine cases of perforation occurred in 142 consecutive patients referred for endoscopic palliation of dysphagia, corresponding to a perforation rate of 6 %. Laser therapy was the main treatment used (argon plasma coagulation or Nd:YAG photocoagulation).

Results: Nonsurgical treatment was successful in six patients (75 %). Two patients died (22 %) as a direct result of esophageal perforation following endoscopic palliation procedures.

Conclusion: These findings show an acceptable mortality rate using a nonsurgical treatment regimen involving broad-spectrum antibiotics, nasogastric suction, and parenteral nutrition, with pleural drainage and endoprosthesis placement in addition when indicated.