gms | German Medical Science

The palliative medical concept of tumors of the upper aerodigestivtract has changed fundamentally in the last few years by use of the CO₂ laser and the modern possibilities of the therapy of stenosis of the upper aerodigestivtract with different stents. This doesn't only have importance for the colleagues in the clinic but also for the general practitioner and nursing support an important think. Incurable tumors of the upper aerodigestivtract cause problems with breathing and swallowing. No longer only the tracheotomy but also the tumor reduction by laser surgery to the improvement of the breathing and swallowing, and the laser surgery in cases of double-sided paresis of the recurrent nerve in patients with thyroid, oesophageal or bronchial carcinoma are very good therapeutical options today. It is possible to reduced obstructing tumor tissue in the larynx, pharynx or the oesophagus with a relative simple operation through the CO₂ laser surgery. Also in the last years the development of stents for the trachea and oesophagus allowed us a minimal invasive therapy of symptoms with a high quality of life. With these modern therapies the tracheotomy can be avoided in many cases for a high quality of life in the remaining lifetime today. In cases of a tracheo-oesophageal fistula, caused by an oesophageal cancer the combined use of tracheal and oesophageal stents allowed o reduce symptoms and get nutrition through natural way. The general practitioner particularly important to this one in the final phase should be informed about these new surgical possibilities in the palliative therapy situation for the transfer to the specialised department and the management in follow-up.