食道癌頸部リンパ節再発による症状に対して緩和ケアを実践した2症例

Our department aggressively performs initial treatment for esophageal carcinoma with multidisciplinary approaches, and not only positively treats patients with recurrence or metastasis but also manages those in an advanced stage by following the wishes of patients and their families as much as possible. However, many patients with esophageal carcinoma develop digestive tract and tracheal problems with progression of the disease, and the palliation of symptoms and continuation of home care often become difficult. In such patients, it is important to secure and maintain the route of hydration and nutrition when oral fluid and food intake becomes difficult, and to control respiratory symptoms for the promotion of home care and palliation of symptoms in the terminal stage.
In this report, we present 2 patients managed by palliative care until death while supporting home care by maintaining enteral nutrition using gastrostomy for esophageal narrowing due to cervical lymph node recurrence, and controlling the cough reflex and dyspnea associated with the development of a cervical lymph node-tracheal fistula through morphine hydrochloride administration.