Foram estudados 121 casos de câncer avançado do esôfago e da cárdia submetidos a tunelização esofágica por via endoscópica ou cirúrgica. Os doentes foram avaliados, tratados e seguidos segundo protocolo que constou de avaliação clínica, exames subsidiários, estadiamento, tratamento, avaliação intra e pós-operatória imediata. Verificaram-se a taxa de mortalidade, período de internação, complicações tardias, sobrevida e causa de óbito. Foram submetidos a tunelização cirúrgica 69 (53%) doentes, e 52 (47%) a tunelização endoscópica. Nos 17 casos de fístula esofagotraqueobrônquica houve sua oclusão eficiente pela tunelização endoscópica em 80% dos casos, com mortalidade de 13,3%, credenciando o método para tratamento dessa complicação tumoral. Os resultados obtidos com a tunelização endoscópica e cirúrgica recomendam seu uso em doentes com câncer avançado do esôfago e da cárdia.
This is a report of 121 cases of advanced esophageal and cardic cancer managed by endoscopic and surgical esophageal intubation. The patients were observed, treated and followed-up by a protocol as follows: clinical observation, subsidiary examinations, staging, intra and post-operative evaluation, mortality, discharge, late follow-up, survival rate and death. There were seventeen patients with esophago-respiratory fistulas, and 15 (88,3%) of them were treated by endoscopic intubation, while the remaining two by surgical intubation. These last two patients deceased because of respiratory complications: the first with tube airway obstruction, and the second with pneumonia. Out of the 15 patients proposed for endoscopic intubation, only one was insuucessful. The seventeen cases of esophago-respiratory fistulas had 80% efficient oclusion by endoscopic intubation and the mortality rate was 13,3%, thus recommending this method for these cases. The results of endoscopic and surgical intubation in this group of patients recommend its use in patients with advanced esophageal and cardic cancer.