[Rendezvous technique for complete hypopharyngeal stenosis. Indications and variations of combined endoscopy].

BACKGROUND: Hypopharyngeal stricture can result from a number of causes including chemoradiotherapy and esophagectomy and leads to inability to swallow with aspiration as well as permanent dependence on a gastrostomy tube. Antegrade dilatation or puncture and local mitomycin C application are often unsuccessful and many patients require extensive surgery.
METHODS: We report three cases of total hypopharyngeal stenosis with different clinical histories. We present our experience using three modifications of the combined anterograde-retrograde endoscopic technique with resection of the stenosis by laser technique under diaphanoscopic control.
RESULTS: In all cases the hypopharyngeal-esophageal passage was restored. No complications occurred as a result of the procedure.
CONCLUSION: Combined direct hypopharyngoscopy with retrograde esophagoscopy represents a viable alternative to more extensive approaches for recanalization of selected obstructing hypopharyngeal stenoses when antegrade identification of the esophageal entrance fails.