Peroral endoscopic 2-way tunneling and lumen restoration for complete esophageal obstruction

Complete esophageal obstruction with a stricture more than 3 cm in length is a challenge for endoscopic and surgical treatments. Lumen restoration may be achieved by the endoscopic tunneling technique.

Using the third-space technique by connecting 2 tunnels created from either side, we created a neo-lumen in a patient with complete esophageal obstruction in the postcricoid region. The lumen was kept patent by placing a temporary fully covered self-expandable metal stent.

Adequate lumen was achieved after stent removal. On follow-up, multiple sessions of dilation were required initially. However, no interventions were required in the last 1 year.

The endoscopic tunneling technique can provide lumen restoration in patients with complete esophageal obstruction.