Ultrathin Endoscope-Assisted Method for the Management of Upper Gastrointestinal Obstruction to Avoid Technical Failure

Abstract

Background/AimsEndoscopic management of upper gastrointestinal obstruction is safe and feasible. However, its technical and clinical success rate is about 90%, which is primarily due to inability to pass a guide-wire through the stricture. The aim of this study was to evaluate the usefulness of an ultrathin endoscope for correct placement of guide wire to avoid technical failure in upper gastrointestinal obstruction.MethodsRetrospective assessment of ultrathin endoscope to traverse the stenosis of the upper gastrointestinal tract in technically difficult cases was performed. Technical and clinical success rates and immediate complications were analyzed.ResultsNine cases were included in this study (eight cases of stent insertion and one case of balloon dilatation). Technical success was achieved in all of the patients (100%) and oral feeding was feasible in all of the cases (100%). Immediate complications, such as migration, perforation, and hemorrhage, did not develop in any of the cases.ConclusionsUltrathin endoscope-assisted method for upper gastrointestinal obstruction is potentially safe and useful to avoid technical failure.

Clinical Outcome of Endoscopic Dilatation Using Ultrathin Endoscope Assisted Method for Esophageal and Pyloric Stricture Related Corrosive Injury: 4 Years Retrospective Study

“…Endoscopic dilatation is the first-line therapy for stricture related corrosive injury [2]. However, due to tight, long or tortuous stricture and insufficient visualization of the distal side of the lesion, endoscopic management is not always possible [4] and require fluoroscopy to ensure proper guidewire placement before dilatation. Because radiologic facilities are not available in every endoscopy units, the initial assessment and treatment may be delayed [11].…”

“…Because radiologic facilities are not available in every endoscopy units, the initial assessment and treatment may be delayed [11]. One of the most important steps in dilatation is the proper placement of the guide wire beyond the stricture [4]. The ultrathin endoscope (≤ 6mm) could pass through the stricture Disclaimer/Publisher's Note: The statements, opinions, and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s).…”

“…MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions, or products referred to in the content. easier than conventional endoscope, allowing the guide wire to be inserted, evaluate distal side of the lesion and measure the length and characteristics of the stenosis [4].…”

“…Endoscopic dilatation (ED) is primary therapy [3]. The ultrathin endoscope assisted method is potentially safe and useful in avoiding technical failure [4]. Methods: Retrospective study of esophageal and/or pyloric stricture after CI who underwent dilatation at Soetomo General Hospital (July 2018 -July 2022).…”

Fluoroscopic-guided stent placement in failed tentative endoscopic approaches to malignant gastroduodenal obstructions

“…The endoscopic placement of SEMS gives greater accessibility to the stricture site and allows the stent to pass directly through the working channel of the endoscope, and it carries a small or no radiation dose compared to fluoroscopic stent placement (3,4). However, endoscopic stent placement is not always feasible, due to a tight or tortuous stricture of the obstructed area and insufficient visualization of the stomach due to remnant food material (11,12). The advantages of fluoroscopic placement are the ease of manipulation of the guide wire, the longer length of the delivery system, and the visualization of the whole lesion under fluoroscopic guidance.…”