A case of endoscopic microwave coagulation therapy through the Witzel's gastrostomy for the malignant esophageal stenosis

Abstract

The case is 81 years old female whose chief complaint was dysphasia since December 1991. Upper gastrointestinal examination revealed about 6cm malignant stenosis in the middle esophagus. To maintain oral food intake, in July 1992, the lesion was coagulated and reduced by 3 times endoscopic microwave coagulation therapy (EMCT) through the Witzel's type gastrostomy which had been made under local anesthesia in February 1992. The endoscopic treatment through the gastrostomy freed patient from the pharyngeal discomfort. Continuous suction of the air through the gastrostomy freed the patient from abdominal fullness. Slight head-up position during the treatment kept the endoscopic view fine because the bloody mucus sprung from coagulating tissue were drained to the stomach without stagnation. Endoscopic therapy though the gastrostomy is worth trying. This route enabled us more than one hour treatment of the EMCT.