English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

One side effect of radiochemotherapy of head and neck malignancies is the development of esophageal stenosis [1,2]. Subsequent therapeutic options include endoscopic balloon dilation or bouginage, with the option to perform combined antegrade/retrograde esophagoscopy in cases of complete esophageal occlusion [3–8], ormajor surgery, suchas esophageal resection,with its high riskof surgical complications [9]. The limitations of endoscopic therapy for complete esophageal closure have been defined and include long-segmental occlusions over 30mm in length, in which case it is recommended to achieve patency of the neo-esophagus using stents, although there is a risk of stent-associated complications [5–8]. This report describes an endoscopic recanalization using a rendezvous maneuver in a 54-year-old patient with complete occlusion of the upper esophagus after primary radiochemotherapy for a hypopharyngeal squamous cell carcinoma. Enteral feeding had been provided via a percutaneous endoscopic gastrostomy (PEG). The patient reported grade IV dysphagia 6 weeks after the radiochemotherapy, which did not resolve with logopedic training. He was seen in our endoscopy unit 12 months later for endoscopic therapy of his suspected upper esophageal stenosis. Endoscopic examination showed complete occlusion of the upper esophagus (●" Fig.1). Simultaneous transoral and retrograde esophagoscopy (via the PEG channel) with fluoroscopy revealed a long-segmental occlusion of about 40mm in length (●" Fig.2). Recanalization was performed by perforating the occlusion with an Eder-Puestow wire passed from Fig.3 Endoscopic views showing recanalization of the esophageal lumen. a A wire is passed into the occluded esophagus by antegrade puncture; b under direct visualization via the retrograde endoscope; c wire-guided bouginage is then performed; and finally d an endoscope is passed through the fully recanalized lumen.

Esophageal recanalization by combined antegrade/retrograde esophagoscopy for radiotherapy-induced complete esophageal occlusion