Peroral guidewire endoscopic recanalization of the esophagus: a simple approach sheds light at the end of the tunnel.
Ontology highlight
ABSTRACT:
SUBMITTER: Zaver HB
PROVIDER: S-EPMC7570203 | biostudies-literature | 2020 Oct
REPOSITORIES: biostudies-literature
Publications
Peroral guidewire endoscopic recanalization of the esophagus: a simple approach sheds light at the end of the tunnel.
Zaver Himesh B HB Corral Juan E JE Francis Dawn L DL Wallace Michael B MB
VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy 20200629 10
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Project description:Background and aimsDefinitive treatment options for refractory dysphagia due to cricopharyngeal bar are limited. We aimed to demonstrate a novel adaptation of peroral endoscopic myotomy to treat this condition (cricopharyngeal peroral endoscopic myotomy [c-POEM]).MethodsThe approach to c-POEM is similar to that in the distal esophagus for the treatment of achalasia. A submucosal injection and overlying mucosal incision are performed, ideally 1.5 to 2 cm upstream of the upper esophageal sphincter, and then a submucosal tunnel is extended beyond the level of the cricopharyngeus. The target muscle is then transected before closure of the mucosotomy.ResultsIn 3 cases of refractory cricopharyngeal bar, c-POEM was successfully performed. Although no major adverse events occurred, significant postprocedural edema at the level of the upper esophageal sphincter prolonged hospitalization in 2 of the 3 patients. After recovery, all patients reported complete resolution of dysphagia and tolerated an unrestricted diet.ConclusionsC-POEM allows reliable and complete muscular division in patients with refractory cricopharyngeal bar who have limited treatment options.
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