Transgastric Endoscopic Submucosal Dissection of Esophageal Cancer with Cervical Stricture

Abstract

A 60-year-old man with a severe cervical stricture and pharyngocutaneous fistula caused by total laryngopharyngectomy and radiochemotherapy (70 Gy) for laryngeal cancer underwent esophagogastroduodenoscopy using a small-caliber endoscope (Olympus GIF-XP290N). A 15-mm superficially depressed lesion in the irradiated area of the cervical esophagus and a 30-mm superficially depressed lesion in the mid esophagus were identified (Fig. 1A-C). Esophagectomy or endoscopic dilation of the cervical stricture was not possible because of the pharyngocutaneous fistula. Thus, we performed endoscopic submucosal dissection (ESD) with a transgastric retrograde approach (Fig. 1D).

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