This study represents the largest retrospective series of colonic stent placement for LBO in ECM patients in the literature. Our technical success rate of 75.9%, clinical success rate of 54.5%, and 3-month stent occlusion rate of 14.7% suggest that stent placement is a viable palliative option for patients with advanced disease because of ECM. Patients with peritoneal carcinomatosis and multifocal disease have reduced technical and clinical success. However, these factors should not dissuade an attempt at stent placement, if risk-to-benefit analysis is favorable.

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Among patients presenting with GERD-like symptoms, the prevalence of Barrett's esophagus may increase markedly if the Montreal definition is adopted. In addition, growing awareness of EE may lead to an increase in the prevalence of this diagnosis. Prospective studies of the management implications of these findings are warranted.

Therefore, a right thoracoscopic approach in the prone position with establishment of pneumothorax was selected. 2 A long esophagomyotomy was created without perforation of the mucosa (Fig. 1b), as confirmed by intraoperative endoscopy. The total length of the myotomy was 15 cm, the operation took 138 min and blood loss was approximately 25 mL. The patient experienced no postoperative complications, and the symptoms related to jackhammer esophagus were considerably improved. The hypercontractile segment was not detectable by HRM after the operation (Fig. 2b).Thirty two months after the operation, the surgery was proven effective without the need for additional treat-ment. To our knowledge, this is the first report to describe successful surgical treatment, using thoracoscopic esophageal long myotomy in the prone position, for a patient with jackhammer esophagus.

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