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Endoscopic removal of obstructing sutures using argon plasma coagulation
VIDEOGIE Todd H. Baron, MD, G. S. Raju, MD, Editors for VideoGIE
Endoscopic removal of obstructing sutures using argon plasma coagulation
Figure 1. Obstructing sutures and debris in the proximal esophagus in a patient with complete dysphagia following Ivor Lewis esophagectomy.
We present 2 unusual cases of persistent dysphagia, months after Ivor Lewis esophagectomy for esophageal adenocarcinoma, caused by retained sutures and staples blocking the passageway of food and fluid through the esophagus. We demonstrate the use of argon plasma coagulation (APC) at 30-W forced coagulation at 1 L/min to completely remove the PDS sutures from the esophagus with minimal damage to the underlying mucosa (Fig. 1; Video 1, available online at www.giejournal.org). This method is safe and effective and can be performed by any endoscopist trained to use APC. After removing This video can be viewed directly from the GIE website or by using the QR code and your mobile device. Download a free QR code scanner by searching “QR Scanner” in your mobile device’s app store.
www.giejournal.org
the obstructing sutures, we proceeded with balloon dilation of the narrowed anastomosis. Suture removal with APC treatment and subsequent stricture dilation led to significant improvement in symptoms and quality of life. DISCLOSURE All authors disclosed no financial relationships relevant to this publication. Jennifer M. Kolb, BA, Icahn School of Medicine at Mount Sinai, New York, New York, Tonya Kaltenbach, MD, MS, Roy Soetikno, MD, MS, Veterans Affairs Palo Alto Health Care System, Stanford University, Palo Alto, California, USA http://dx.doi.org/10.1016/j.gie.2013.10.049
Volume 79, No. 3 : 2014 GASTROINTESTINAL ENDOSCOPY 373
Endoscopic removal of obstructing sutures using argon plasma coagulation
Figure 1. Obstructing sutures and debris in the proximal esophagus in a patient with complete dysphagia following Ivor Lewis esophagectomy.
We present 2 unusual cases of persistent dysphagia, months after Ivor Lewis esophagectomy for esophageal adenocarcinoma, caused by retained sutures and staples blocking the passageway of food and fluid through the esophagus. We demonstrate the use of argon plasma coagulation (APC) at 30-W forced coagulation at 1 L/min to completely remove the PDS sutures from the esophagus with minimal damage to the underlying mucosa (Fig. 1; Video 1, available online at www.giejournal.org). This method is safe and effective and can be performed by any endoscopist trained to use APC. After removing This video can be viewed directly from the GIE website or by using the QR code and your mobile device. Download a free QR code scanner by searching “QR Scanner” in your mobile device’s app store.
www.giejournal.org
the obstructing sutures, we proceeded with balloon dilation of the narrowed anastomosis. Suture removal with APC treatment and subsequent stricture dilation led to significant improvement in symptoms and quality of life. DISCLOSURE All authors disclosed no financial relationships relevant to this publication. Jennifer M. Kolb, BA, Icahn School of Medicine at Mount Sinai, New York, New York, Tonya Kaltenbach, MD, MS, Roy Soetikno, MD, MS, Veterans Affairs Palo Alto Health Care System, Stanford University, Palo Alto, California, USA http://dx.doi.org/10.1016/j.gie.2013.10.049
Volume 79, No. 3 : 2014 GASTROINTESTINAL ENDOSCOPY 373