Tunnel endoscopic interventions in esophageal diseases

The aim of the study is the evaluation of results of endoscopic tunnel interventions in submucosal tumors and achalasia.

Material and methods. Endoscopic tunnel interventions during 2017–2020 years were performed in 80 patients (34-men, 46-women). The duration of the age ranged from 15 to 72 years. The indications for interventions were: achalasia in 53, subepithelial tumors in 27.

Results. During the intervention, complications occurred in 22 patients. Among the complications: carboxyperitoneum in 16 cases, carboxytorax in 2, esophageal mucosa perforation in 2, bleeding moderate intensity bleeding in 2. Most of the complications (20) were in patients with esophageal achalasia. Postoperative complications were observed in two patients operated for esophageal achalasia (bleeding and hematoma, esophageal mucosa necrosis). All patients were treated by using conservative methods. The results of the interventions were assessed in terms of 1 month to 3 years. There were no violations of food or liquid the passage through the cardia. Patients after operation for submucous tumors of the esophagus had no complaints. The main complaint of patients after myotomy was heartburn. Endoscopic examination revealed erosive reflux esophagitis (A-C) in 18 patients.

Conclusion. Tunnel endoscopic interventions in patients with esophageal achalasia and submucous tumors are highly effective and low-traumatic, allowing relatively safe restoration of the patency of the cardia and removal of the subepithelial neoplasm. The problem of gastroesophageal reflux after oral endoscopic myotomy requires further accumulation of data in order to develop optimal tactics. The limiting factor for the these operations performance is the material and technical equipment of medical institutions and the lack of trained specialists.

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