JLE

Hépato-Gastro & Oncologie Digestive

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Management of the complications of interventional oesophagoscopy Volume 16, issue 3, mai-juin 2009

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Authors
Service d’hépatogastroentérologie, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France

Interventional gastrointestinal endoscopy of the oesophagus involves treatment of pre-neoplastic and neoplastic lesions and benign lesions. The techniques of endoscopic mucosal resection and more recently endoscopic submucosal dissection have developped greatly and represent an alternative to surgery. Surgical treatment has a high morbidity and mortality especially among frail patients (older patients, alcohol-smoking patients in epidermoid carcinoma of the oesophagus, etc.). Bleeding and perforation are the main complications and treatment is most often endoscopic and medical. However, the use of surgical treatment should be possible if necessary. Dynamic phototherapy is a treatment of superficials tumors the oesophagus. Complications are bleeding, perforation and stenosis and their management is the same as mucosal resection. Preventive measures for photosensitivity reactions must be involved. Self-expanding metal stents can be used as palliative treatment for malignant oesophageal obstruction. Benign strictures can be successfully treated by endoscopic balloon dilation or extractable prosthesis. The main complications are perforation and prosthesis migration.