PALLIATION OF MALIGNANT ESOPHAGEAL OBSTRUCTION BY ENDOSCOPIC ALCOHOL INJECTION

Thirty six-patients with inoperable cancers of the oesophagus or gastr ic tumour in the cardia were treated by endoscopic alcohol injection. After dilatation using Savary dilators, absolute alcohol was injected in 0.5-1 ml aliquots into protuberant parts using a sclerotherapy need le. The mean volume per session was 7.8 ml. The mean dysphagia score i mproved from 2.7 before treatment to 1.4 after treatment (p < 0.001). Complications included mediastinitis in one patient and tracheo-oesoph ageal fistulas in two patients. The mean duration of palliation before the development of recurrent dysphagia was 35 days. The mean survival was 82 days. Endoscopic alcohol injection is effective in relieving m alignant dysphagia. This inexpensive and easily available technique me rits comparative studies with more established forms of therapy, such as laser photocoagulation.