Endoscopic dilation of complete oesophageal obstructions with a combined antegrade-retrograde rendezvous technique

Table 1 Functional oral intake scale items[15]

Level 1	Nothing by mouth
Level 2	Tube dependent with minimal attempts of food or liquid
Level 3	Tube dependent with consistent oral intake of food or liquid
Level 4	Total oral diet of a single consistency
Level 5	Total oral diet with multiple consistencies, but requiring special preparation or compensations
Level 6	Total oral diet with multiple consistencies without special preparation, but with specific food limitations
Level 7	Total oral diet with no restrictions

Table 2 Patients’ characteristics and outcomes

No	Sex	Age	Diagnosis	Prior radiotherapy (max dose i. Gy)	Surgery	Chemotherapy	Technical success	FOIS	Notes
1	F	68	Hypopharyngeal carcinoma T3 N0 and oropharyngeal carcinoma T2 N0	68	No	Yes	Yes	6
2	M	59	Complete occlusion of sinus piriformis after Lyell syndrome	No	No	No	Yes	6
3	M	54	Squamous carcinoma of the cervical oesophagus cT3 cN2 cM0	66	No	Yes	No	-	Died before follow-up with PEG-tube
4	M	74	Proximal oesophageal carcinoma and carcinoma of the glottic larynx cT2 cN0	Glottis: 66 Oesophagus: 68	Yes	Yes	Yes	-	Died before follow-up with PEG-tube
5	M	68	Carcinoma of the hypopharynx	70	Yes	No	Yes	2
			initial cT2c No cM0
6	M	71	Carcinoma of the larynx cT3 cN2	68	No	No	Yes	7

FOIS: Functional oral intake scale.

Table 3 Technical details and clinical success of endoscopic rendezvous dilation in patients with complete obstruction of the proximal oesophagus

Type of antegrade endoscope
Rigid, flexible	4, 2
Method of retrograde puncture of the obstruction
VisiGlide guidewire	4/6
Argon beamer	1/6
First stricture dilation
With Savary bougie	5/5
Size	median 10 mm (range 6 - 10 mm)
Subsequent dilations before discharge
With balloon	3/5 patients
size range	15-16.5 mm
With bougie	2/5 patients
size range	12-15 mm
Success rate of rendezvous procedures
Technical success	5/6 (83%)
Need for recurrent dilations after discharge	5/5
Swallowing success
Time of follow-up, median (range)	27 mo (2-115)
Need for long-term PEG-tube	3/6
Functional oral intake
Tube dependent with minimal attempts of food or liquid (level 2)	1
Total oral diet with multiple consistencies without special preparation, but with specific food limitations (level 6)	2
Total oral diet with no restrictions (level 7)	1
Complications of rendezvous procedures
Mediastinal emphysema (no surgery needed)	1/6
Death	0/6

FOIS: Functional oral intake scale.