| Endoscopic submucosal dissection (ESD) for superficial esophageal cancer has become a standard procedure in Japan. However, lesions at the pharyngoesophageal junction, still pose a significant challenge due to poor visibility and scope maneuverability caused by physiologic narrowing, making them technically difficult. Recently, our institution has introduced the combined use of laryngeal elevation and a novel thin-therapeutic endoscope for pharyngoesophageal junction ESD. Pharyngoesophageal junction ESD is performed in collaboration with the otolaryngologists. Laryngeal elevation is initially performed by the otolaryngologists to improve visibility of the pharyngoesophageal junction from the hypopharynx. The novel thin-therapeutic endoscope, Fujifilm EG-840TP (TP), features a slim outer diameter of 7.9 mm, an accessory channel diameter of 3.2 mm, and a 160° downward angle function, providing superior curvature for improved maneuverability in tight spaces. TP facilitates easy creation of mucosal flaps during pharyngoesophageal junction ESD, reducing complications and shortening treatment time. We present two pharyngoesophageal junction ESD cases using the above combined techniques. In both cases, prophylactic measures against stricture formation, including local triamcinolone injection and polyglycolic acid (PGA) sheet coverage, were implemented. No significant stenosis was observed postoperatively. In conclusion, the combination of laryngeal elevation and thin-therapeutic endoscopy is beneficial for pharyngoesophageal junction ESD. A detailed presentation including video will be given on the day. |
