Pulsion intubation of malignant tumours at the oesophagogastric junction, and value of the “Air insufflation test”

Abstract

Tumours at or within 3 cm of the oesophago-gastric junction are usually difficult to intubate by the pulsion method and carry an increased risk of gastric or oesophageal perforation using previously described techniques. While these techniques are perfectly adequate for pulsion intubation of tumours at other levels of the oesophagus, most surgeons consider the tumour at the oesophago-gastric junction unsafe to intubate by the “push” method using the rigid oesophagoscope. Using relatively simple manoeuvres it is possible to safely intubate all the patients with malignant strictures at the oesophagogastric junction, using the push technique which is quick, easy to execute, requires a short anaesthetic, upsets the patient minimally, and in most cases permits discharge of the patient from hospital within 24~48 hours.