Endoscopic management of radiation-induced complete upper esophageal obstruction with an antegrade-retrograde rendezvous technique

2006 ◽  
Vol 64 (5) ◽  
pp. 822-828 ◽  
Author(s):  
John T. Maple ◽  
Bret T. Petersen ◽  
Todd H. Baron ◽  
Jan L. Kasperbauer ◽  
Louis M. Wong Kee Song ◽  
...  
2005 ◽  
Vol 100 ◽  
pp. S223-S224
Author(s):  
John T. Maple ◽  
Bret T. Petersen ◽  
Todd H. Baron ◽  
Jan L. Kasperbauer ◽  
Mark V. Larson ◽  
...  

2011 ◽  
Vol 125 (7) ◽  
pp. 761-764 ◽  
Author(s):  
M P Kos ◽  
E F David ◽  
H F Mahieu

AbstractBackground:Strictures of the hypopharynx and oesophagus are frequently observed following (chemo)radiation. Anterograde dilatation of a complete stenosis carries a high risk of perforation. An alternative is described: a combined anterograde–retrograde approach.Case report:A 75-year-old man developed complete stenosis of the oesophageal inlet after primary radiotherapy for laryngeal carcinoma and full percutaneous endoscopic gastrostomy feeding. To prevent creation of a false route into the mediastinum, a dilatation wire was introduced in a retrograde fashion into the oesophagus, through the gastrostomy opening. The wire was endoscopically identified from the proximal side and then passed through a perforation created by CO2 laser. Anterograde dilatation was safely performed, and the patient returned to a normal diet. There is consensus in the literature that blind anterograde dilatation carries a high risk of perforation; therefore, an anterograde–retrograde rendezvous technique is advisable.Conclusion:In cases of complete obstruction of the oesophageal inlet, anterograde–retrograde dilatation represents a safe technique with which to restore enteric continuity.


2006 ◽  
Vol 63 (5) ◽  
pp. AB245 ◽  
Author(s):  
Jennifer Kaufman ◽  
Mark Schattner ◽  
Richard Wong ◽  
Nancy Lee ◽  
Jay Boyle ◽  
...  

2017 ◽  
Vol 112 ◽  
pp. S199-S201
Author(s):  
Maoyin Pang ◽  
Michael Bartel ◽  
Omar Mousa ◽  
Eelco C. Brand ◽  
Bhaumik Brahmbhatt ◽  
...  

Author(s):  
Sara Teles de Campos ◽  
Ricardo Rio-Tinto ◽  
Paulo Fidalgo ◽  
Miguel Bispo ◽  
Susana Marques ◽  
...  

<b><i>Background:</i></b> The approach to esophageal obstruction or discontinuity remains challenging and often involves complex reconstructive surgeries. The rendezvous endoscopic technique might be interesting in cases of complete esophageal obstruction. <b><i>Case Presentation:</i></b> Herein we describe a successful case of endoscopic recanalization of the esophageal lumen in a patient with a long-standing esophageal discontinuity resulting from several surgeries and chemoradiation for a squamous cell carcinoma of the hypopharynx, ending in a major cervical amputation, construction of a neopharynx, and definitive surgical closure of the superior esophagus with a PEG placement. With a rendezvous technique (peroral and through the gastrostomy) and under radiographic guidance, puncture from the neopharynx into the distal esophagus was performed, followed by balloon dilation and covered metal stent placement in order to reconstruct a neoesophagus. Five weeks later, the stent was removed (using a stent-in-stent technique). No complications occurred. The patient has been able to eat soft food and is being kept under regular endoscopic surveillance to control/treat a luminal stenosis of the neoesophagus. <b><i>Conclusions:</i></b> This case report illustrates a successful endoscopic treatment of post-surgical complete esophageal obstruction. This approach should be considered in the therapeutic armamentarium of these difficult clinical settings.


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