Feasibility and therapeutic outcome of endoluminal magnetic compression anastomosis for caustic esophageal stricture

Objective To explore the feasibility and therapeutic outcome of endoluminal magnetic compression anastomosis for caustic esophageal stricture after esophageal alkline agent burns. Methods At over half a month after ingesting a small amount of strong alkali, esophageal stenotic symptoms appeared in a 1-year-old child diagnosed as corrosive esophageal stricture. Six dilatations of esophagus were performed without obvious effect. And this patient was advised to undergo an endo-luminal magnetic compression anastomosis. After gastrostomy, the magnetic rings were placed through mouth and stoma of gastrostomy under general anesthesia, respectively. The compressed rings were removed from stoma of gastrostomy after completions of anastomosis. Chest radiography was used for assessing the location and angle of magnetic rings. The postoperative follow-up interval was 1 month. Results During an operative duration of 60min, there was no onset of intraoperative complications. Within the first three days, salivation with paroxysmal chest pain appeared and gradually alleviated. Daily chest radiography showed no sign of ectopic location, torsion, or angulation of magnetic rings. Distance between magnetic rings gradually decreased and was less than 1mm at Day 3. And endoscopy at Days 10 and 14 revealed that magnetic rings in esophagus were in state of magnetic attraction and moved slightly. The magnetic rings were removed successfully at Day 18 and endoscopy showed a smooth esophageal mucosa without scarring and no obvious infiltration/hemorrhage/rupture at the site of anastomosis. Conventional pathology of compressed tissue showed necrotic. At the successive six-month follow-ups, two dilatations were performed. The boy had no stenotic esophageal symptoms during ingestion. Re-examining endoscopy showed normal. Conclusions Endoluminal magnetic compression anastomosis is mini-invasive and efficacious for short and incomplete-atresia caustic esophageal stricture. Key words: Esophageal stenosis; Esophagoplasty; Esophagoscopy