2023 Volume 65 Issue 2 Pages 117-124
A 76-year-old man who presented with dysphagia was admitted to our hospital for management of esophagogastric junction cancer and underwent subtotal esophagectomy with gastric tube reconstruction. Endoscopic and video-fluoroscopic evaluation performed on the 7th postoperative day revealed complete obstruction of the esophagogastric anastomosis, which was attributed to an esophageal mucosal pinch injury during anastomosis. We attempted endoscopic recanalization of the obstructed anastomosis (rendezvous endoscopy) from both the oral and gastric ends. We accessed the gastric end by opening the surgical wound and nicking the gastric tube under general anesthesia. Both the oral and gastric endoscopes could detect the contralateral endoscopic light through the obstructed esophageal mucosa. Using the Hook knife-J, we safely punctured along the appropriate direction of the esophageal mucosa. After incising the obstructed segment, a guidewire was inserted to perform balloon catheter dilation without any adverse events. A literature search revealed that this report is the first to describe rendezvous endoscopic recanalization for management of complete obstruction of the esophagogastric anastomosis after subtotal esophagectomy. Rendezvous endoscopic intervention may avoid surgical reanastomosis in cases of complete esophageal obstruction.
