Clinical Endoscopy

Case Reports

Two-Stage Peroral Endoscopic Myotomy for Sigmoid-Type Achalasia: Hak Su Kim, Hee Kyung Kim, Weon Jin Ko; Clin Endosc 2020;53(2):232-235. Published online July 16, 2019; DOI: https://doi.org/10.5946/ce.2019.067

Abstract PDF Supplementary Material PubReader ePub: Peroral endoscopic myotomy (POEM) has been recently considered as the first treatment option for achalasia. The standard POEM procedures are often successful in most patients, but sometimes technical challenges are encountered. We report a new technique that is divided between two tunneling sites in the esophagus for sigmoid-type achalasia. A 40-year-old male patient with dysphagia for 10 years was diagnosed with a sigmoid-shaped esophagus at our hospital. We devised a two-stage myotomy technique to treat sigmoidtype achalasia. The myotomy was first performed in the upper part of the greater flexion area and then in the lower part of the flexion. We termed this method “two-stage POEM”, which was successfully performed without any complications. This new POEM method can also be used to improve symptoms in patients with achalasia who have a structural deformity that may result in a high change of treatment failure.

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Endoscopic Submucosal Dissection Followed by Concurrent Chemoradiotherapy in Patients with Early Esophageal Cancer with a High Risk of Lymph Node Metastasis: Hee Kyung Kim, Weon Jin Ko, Chang-Il Kwon, Ga Won Song, In Kyun Yoo, Ji Hyun Song, Hak Su Kim, Joo Young Cho; Clin Endosc 2019;52(5):502-505. Published online May 14, 2019; DOI: https://doi.org/10.5946/ce.2018.176

Abstract PDF PubReader ePub

Endoscopic submucosal dissection is recommended as an alternative therapy for early esophageal cancer. However, achieving curative resection in this procedure remains controversial since precise prediction of lymph node metastasis can be difficult. Here, we present the preliminary results of endoscopic submucosal dissection followed by concurrent chemoradiotherapy for early esophageal cancer with a high risk of lymph node metastasis. From May 2006 to January 2014, six patients underwent concurrent chemoradiotherapy after endoscopic submucosal dissection with a median follow-up period of 63 months. No complications were encountered during concurrent chemoradiotherapy. Although local recurrence did not occur in all patients, two patients were diagnosed with metachronous cancer. Overall, the survival rate was 100%. Thus, endoscopic submucosal dissection followed by concurrent chemoradiotherapy may be a feasible treatment for early esophageal cancer in patients with a high risk of lymph node metastasis. Future prospective large-scale studies are warranted to confirm our results.

Citations

Citations to this article as recorded by

Unveiling Therapeutic Targets for Esophageal Cancer: A Comprehensive Review
Rakesh Acharya, Ananya Mahapatra, Henu Kumar Verma, L. V. K. S. Bhaskar
Current Oncology.2023; 30(11): 9542. CrossRef
Editorial “Discrepancy Between the Clinical and Final Pathological Findings of Lymph Node Metastasis in Superficial Esophageal Cancer”
Rian M. Hasson, Joseph D. Phillips
Annals of Surgical Oncology.2019; 26(9): 2662. CrossRef

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1 Web of Science
2 Crossref

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