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J Laryngol Otol. 2011 Jul;125(7):761-4. doi: 10.1017/S0022215111001058.

Anterograde-retrograde rendezvous approach for radiation-induced complete upper oesophageal sphincter stenosis: case report and literature review.

Author information

1
Department of Otolaryngology/Head and Neck Surgery, Free University Medical Center, Amsterdam, The Netherlands. martijn.kos@gmail.com

Abstract

BACKGROUND:

Strictures of the hypopharynx and oesophagus are frequently observed following (chemo)radiation. Anterograde dilatation of a complete stenosis carries a high risk of perforation. An alternative is described: a combined anterograde-retrograde approach.

CASE REPORT:

A 75-year-old man developed complete stenosis of the oesophageal inlet after primary radiotherapy for laryngeal carcinoma and full percutaneous endoscopic gastrostomy feeding. To prevent creation of a false route into the mediastinum, a dilatation wire was introduced in a retrograde fashion into the oesophagus, through the gastrostomy opening. The wire was endoscopically identified from the proximal side and then passed through a perforation created by CO2 laser. Anterograde dilatation was safely performed, and the patient returned to a normal diet. There is consensus in the literature that blind anterograde dilatation carries a high risk of perforation; therefore, an anterograde-retrograde rendezvous technique is advisable.

CONCLUSION:

In cases of complete obstruction of the oesophageal inlet, anterograde-retrograde dilatation represents a safe technique with which to restore enteric continuity.

PMID:
21693080
DOI:
10.1017/S0022215111001058
[Indexed for MEDLINE]

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