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Endoscopy 2003; 35(8): S9-S13
DOI: 10.1055/s-2003-41538
Esophagus
© Georg Thieme Verlag Stuttgart · New York

Endoscopic Palliation of Esophageal Malignancy

R.  A.  Kozarek1
  • 1Chief of Gastroenterology, Virginia Mason Medical Center, Clinical Professor of Medicine, University of Washington School of Medicine, Seattle, Washington
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Publication History

Publication Date:
20 August 2003 (online)

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Historically, the development and marketing of the neodymium-yttrium-aluminum-garnet (Nd:YAG) laser was associated with the insertion of markedly fewer conventional prostheses for the palliation of malignant dysphagia. Subsequently, the introduction of self-expandable metal stents (SEMS) has, in turn, led to a diminished role not only for laser therapy but also for other ablative modalities, including bipolar cautery, argon plasma coagulation (APC), and the injection of caustics. Two ablative modalities deserve ongoing consideration, but not because they have been proven to be better or more cost-effective than SEMS. These include photodynamic therapy (PDT), because of its potential to ablate large areas of low-grade malignancy, and injection of chemotherapeutic agents or T-lymphocytes sensitized to an individual malignancy. The latter, while theoretically promising, will require considerably more study before widespread clinical application.

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R. A. Kozarek, M. D.

Section of Gastroenterology · Virginia Mason Medical Center

1100 Ninth Avenue · Seattle, WA 98111

Phone: 206–223–6934

Fax: 206–223–6379

Email: gasrak@vmmc.org