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Michael C. Sulz 1 , Reto Bertolini 1* , Paul Martin Putora 2 , Franziska
Albrecht 1 , Martina A. Broglie-Däppen 3 , Sandro J. Stöckli 3 ,
Christa Meyenberger 1 . *The first two authors contributed
equally to the abstract.

1 Gastroenterology and Hepatology, Kantonsspital St. Gallen,
St. Gallen, 2 Radiation Oncology, Kantonsspital St. Gallen, St.
Gallen, 3 Head and Neck Surgery, Kantonsspital St. Gallen, St.
Gallen, Switzerland

Background: Complete obliteration in the proximal
oesophagus can occur after radiotherapy in patients with head
and neck cancers. If antegrade dilatation is unsuccessful, retro-
grade endoscopic rendez-vous dilatation is an option to restore
oesophageal patency and to resolve patients from percut-
aneous endoscopic gastrostomy (PEG) tubes. Our aim was to
focus on the techniacl and long-term clinical outcome.
Methods: This case series included all patients in one tertiary
referral centre with complete obliteration in the proximal
oesophagus over a 10-year period, who were unable to swallow
and were treated by retrograde endoscopic rendez-vous
dilatation. Technical success was defined as achievement of a
retrograde puncture and passage with the endoscope to apply a
nasogastric tube. The long-term clinical success was defined as
either independency from PEG-tube and/or ability of oral food
intake.
Results: 6 patients (5 males; median age 71 years) underwent
retrograde endoscopic rendez-vous dilatation. Technical
success was achieved in 5 of 6 patients. At follow-up (median
27 months) half of the patients stayed dependent on the PEG-
tube, the others had oral diet.
Conclusions: This approach offers an alternative to high-risk
blind dilatation or surgery in patients with complete proximal
oesophageal obliteration. We found that technical success was
fairly high. However in long-term follow up only half of the
patients remained independent from PEG-tube.