Ultrathin Endoscopy for Gastrointestinal Strictures

Abstract

UTE is a useful tool for the evaluation of patients with advanced GI strictures. It provides a complete diagnostic endoscopy in most patients and gives an opportunity for therapeutic endoscopic procedures.

Transnasal endoscopy: no gagging no panic!

“…Dilatation of such strictures can be done safely as endoscopic placement of a guidewire is possible in most cases via an UT endoscope even in tight strictures without the need for fluoroscopy 77. This is in line with the BSG guidelines that recommend using a wire-guided technique for performing oesophageal dilatations 78.…”

Use of transnasal endoscopy for screening of esophageal squamous cell carcinoma in high‐risk patients: Yield rate, completion rate, and safety

“…reported that after surgery or irradiation up to 21% of patients have hypopharyngeal/upper esophageal strictures, which may further prevent intubation of a conventional endoscope into the esophagus. The ultrathin endoscope, whether via the transoral or transnasal route, has been used in patients with gastrointestinal strictures with a success rate of approximately 78% . In the present study, the overall completion rate of an ultrathin endoscope via the transnasal route was as high as 96.7% in HNSCC patients, which indicates the feasibility of unsedated TNE in HNSCC patients.…”

“…The ultrathin endoscope, whether via the transoral or transnasal route, has been used in patients with gastrointestinal strictures with a success rate of approximately 78%. 21,22 In the present study, the overall completion rate of an ultrathin endoscope via the transnasal route was as high as 96.7% in HNSCC patients, which indicates the feasibility of unsedated TNE in HNSCC patients.…”

Ultrathin endoscope‐assisted self‐expandable metallic stent placement following initial unsuccessful attempt in malignant upper gastrointestinal obstruction

“…However, in cases of patients with severe tortuous and angulated strictured lumen, insufficient visualization of the stricture orifice, or undetermined length of the strictured segment, correct placement of a guidewire is very difficult. To overcome this technical difficulty, some authors tried alternative therapeutic interventions, including dilation and stenting with UTE as the guidewire delivery system . Indeed, it is very logical to use UTE to assess the etiology and type of stenosis, to complete diagnostic endoscopy and to also provide an opportunity for a therapeutic procedure.…”

“…To overcome this technical difficulty, some authors tried alternative therapeutic interventions, including dilation and stenting with UTE as the guidewire delivery system. 12,13 Indeed, it is very logical to use UTE to assess the etiology and type of stenosis, to complete diagnostic endoscopy and to also provide an opportunity for a therapeutic procedure. These reports clearly showed that any kind of intervention, such as dilatation, stenting, and percutaneous endoscopic gastrostomy, might be possible over the guidewire under fluoroscopy only after traversing severe strictures under UTE visualization.…”