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Endoscopic dilation of complete oesophageal obstructionswith a combined antegrade-retrograde rendezvoustechnique

World Journal of Gastroenterology 2016年第7期22卷 2366-2372页

作者： Reto Bertolini Christa Meyenberger Paul Martin Putora Franziska Albrecht Martina Anja Broglie Sandro J Stoeckli Michael Christian Sulz Division of Gastroenterology and Hepatology Kantonsspital St.Gallen9007 St.GallenSwitzerland Department of Radiation Oncology Kantonsspital St.Gallen9007 St.GallenSwitzerland Department of Otorhinolaryngology Head and Neck SurgeryKantonsspital St.Gallen9007 St.GallenSwitzerland

AIM: To investigate the combined antegraderetrograde endoscopic rendezvous technique for complete oesophageal obstruction and the swallowing ***: This single-centre case series includes consecutive patients who were unable to swallow due to complete oesophageal obstruction and underwent combined antegrade-retrograde endoscopic dilation(CARD) within the last 10 years. The patients' demographic characteristics, clinical parameters, endoscopic therapy, adverse events, and outcomes were obtained retrospectively. Technical success was defined as effective restoration of oesophageal patency. Swallowing success was defined as either percutaneous endoscopic gastrostomy(PEG)-tube independency and/or relevant improvement of oral food intake, as assessed by the functional oral intake scale(FOIS)(≥ level 3).RESULTS: The cohort consisted of six patients [five males; mean age 71 years(range, 54-74)]. All but one patient had undergone radiotherapy for head and neck or oesophageal cancer. Technical success was achieved in five out of six patients. After discharge, repeated dilations were performed in all five patients. During follow-up(median 27 mo, range, 2-115), three patients remained PEG-tube dependent. Three of four patients achieved relevant improvement of swallowing(two patients: FOIS 6, one patient: FOIS 7). One patient developed mediastinal emphysema following CARD, without a need for ***: The CARD technique is safe and a viable alternative to high-risk blind antegrade dilation in patients with complete proximal oesophageal obstruction. Although only half of the patients remained PEG-tube independent, the majority improved their ability to swallow.

关键词： Oesophageal obstruction Rendezvoustechnique Combined antegrade-retrograde endoscopicdilation Endoscopic dilation Head and neck cancer Radiotherapy

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