Dhaliwal Harpal S, Kumar Nitin, Siddappa Pradeep Kumar, Singh Ripudaman, Sekhon Jogeet Singh, Masih Jaspal, Abraham Justin, Garg Sameer
Department of Gastroenterology, Christian Medical College and Hospital, Ludhiana 141012, Punjab, India.
Department of Internal Medicine, Christian Medical College and Hospital, Ludhiana 140012, Punjab, India.
World J Gastrointest Endosc. 2018 Nov 16;10(11):367-377. doi: 10.4253/wjge.v10.i11.367.
To investigate the role of a novel minimally invasive endoscopic technique in the management of tight near-total corrosive strictures of the proximal esophagus involving the hypopharynx.
Two patients with near-total corrosive strictures of the proximal esophagus involving the hypopharynx were managed with the novel endoscopic technique. The technique involved passing a 0.025-inch flexible guide-wire across the stricture, and stricture dilatation, using 10F coaxial diathermy and balloon dilators, followed by electro-incision of the proximal aspect of the residual eccentric stricture by means of a novel approach using a wire-guided sphincterotome.
Both patients were successfully managed on an outpatient department basis with the complete relief of symptoms and resolution of strictures on endoscopy and an esophagogram. No adverse events were seen during or after the procedure. There was no recurrence of symptoms at a follow-up of over a year in both cases. There was a significant improvement in the body mass index of both patients after the procedure.
We report a novel flexible endoscopic technique for the management of complex hypopharyngo-esophageal strictures. In experienced hands, the procedure is relatively simple, safe and effective with a durable response.
探讨一种新型微创内镜技术在治疗累及下咽的近端食管紧密型近全腐蚀性狭窄中的作用。
对2例累及下咽的近端食管近全腐蚀性狭窄患者采用新型内镜技术进行治疗。该技术包括将一根0.025英寸的柔性导丝穿过狭窄部位，然后使用10F同轴透热疗法和球囊扩张器进行狭窄扩张，接着通过一种使用导丝引导括约肌切开刀的新方法对残余偏心狭窄的近端进行电切。
两名患者均在门诊成功接受治疗，症状完全缓解，内镜检查和食管造影显示狭窄消失。术中及术后均未出现不良事件。随访一年以上，两例患者均未出现症状复发。术后两名患者的体重指数均有显著改善。
我们报告了一种用于治疗复杂下咽食管狭窄的新型柔性内镜技术。在经验丰富的医生手中，该手术相对简单、安全且有效，效果持久。
