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CC BY-NC-ND 4.0 · Endosc Int Open 2022; 10(05): E707-E711
DOI: 10.1055/a-1781-6098
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Forward-viewing EUS-guided esophageal repermeabilization

Sara Campos
1   Gastroenterology Department, Digestive Unit, Champalimaud Foundation, Lisbon, Portugal
,
Marianna Arvanitakis
2   Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology, Erasmus University Hospital – Université Libre de Bruxelles, Brussels, Belgium
,
Ricardo Rio-Tinto
1   Gastroenterology Department, Digestive Unit, Champalimaud Foundation, Lisbon, Portugal
,
Jacques Deviere
1   Gastroenterology Department, Digestive Unit, Champalimaud Foundation, Lisbon, Portugal
2   Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology, Erasmus University Hospital – Université Libre de Bruxelles, Brussels, Belgium
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Complete esophageal obstruction with associated aphagia is a severe complication of of locoregionally advanced head and neck cancer. Endoscopic combined anterograde-retrograde rendezvous procedure with repermeabilization and dilatation has been increasingly adopted to manage it. However, in cases of a large gap between the proximal and distal esophagus and absence of transillumination, this classical approach is not possible. In this report, we describe a novel, relatively simple and safe method of endoscopic anterograde-retrograde rendezvous esophageal repermeabilization using forward-viewing endoscopic ultrasound (EUS). EUS allows clearly targeting of the lumen and puncture, avoiding potential interposed vessels. Specifically, this type of echoendoscope, designed with a short rigid portion and wide angulation capability that increases maneuverability and controlled visualization and puncture in the direct axis of the scope, has an additional advantage in cases such as ours, in which narrowing of both esophageal ends could hamper performance of a puncture with a regular side-viewing echoendoscope.



Publication History

Received: 25 August 2021

Accepted after revision: 03 December 2021

Article published online:
13 May 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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