ESOPHAGEAL ENDOPROSTHESIS BY LAPAROGASTROSCOPY WITH TRANSTUMORAL DRILLING – PALLIATIVE THERAPEUTIC OPTION IN ADVANCED GASTROESOPHAGEAL JUNCTION ADENOCARCINOMA
Abstract:
The early diagnosis of the esophageal-gastric junction adenocarcinoma, both in our country and in many parts of the world is not possible yet, unless “accidentally”. The incidence of the disease is increasing, most frequently the lesion is diagnosed in advanced stages, thus, few patients can benefit from treatment with radical intent. The main treatment in these cases is often palliative; currently, the use of the transtumoral esophageal prosthesis assembled endoscopically represents the method of choice, but due to the technical impossibility to cross the tumoral stenosis with the endoscope or due to the endoscopist’s concerns in the case of the “sensitive” areas (poles of the esophagus), there also are failures of prosthesis. In this context, we aim at analysing the process of endoscopic endoprosthesis by transtumoral drilling as a solution to the “reserves” or failures of the endoscopic prosthesis as a technical, biological and social alternative to the disabling gastrostomy in the case of the patients with neoplastic eso-gastric stenosis. Although the number of patients diagnosed with esophageal-gastric junction adenocarcinoma who received laparoscopic arthroplasty by transtumoral drilling is limited, this original procedure brought us satisfaction whenever we turned to this approach, both in the above mentioned pathology and in other oesophageal diseases
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