Ultrathin endoscopy for gastrointestinal strictures

The assessment and treatment of advanced gastrointestinal (GI) strictures, which are defined as the inability to pass through the strictured segment with standard endoscopes, might require radiological work-up, repeated endoscopies and surgery. The aim of the present study was to assess the role of ultrathin endoscopy (UTE) for the evaluation and treatment of advanced GI strictures.

Patients in whom an initial diagnostic upper or lower endoscopy attempt was incomplete because of a tight stricture underwent a second procedure with a UTE (5.9 mm diameter) in the same session. An interventional endoscopic therapy was also carried out according to the etiology and nature of the stricture using the same UTE. Diagnostic and therapeutic outcomes were recorded and followed up prospectively. The study was conducted in a tertiary endoscopy center.

During a one and half year study period, 62 patients (51 at upper and 11 at lower endoscopy) were detected with advanced GI stricture among 8456 diagnostic upper and 3815 lower endoscopy patients. A complete endoscopic examination was successful with UTE in 40 (78%) patients with upper and in nine patients (82%) with lower GI strictures. An interventional procedure was also carried out in 16 patients with the assistance of UTE.

UTE is a useful tool for the evaluation of patients with advanced GI strictures. It provides a complete diagnostic endoscopy in most patients and gives an opportunity for therapeutic endoscopic procedures.