| Peer-Reviewed

A Novel J-Maneuver Withdrawal Method During Gastroscopy to Dilate the Benign Distal Esophageal Stenosis

Received: 28 February 2022    Accepted: 24 March 2022    Published: 31 March 2022
Views:       Downloads:
Abstract

Background: Bouginage and pneumatic dilation are the first treatments for benign esophageal stenosis or stricture. Aim of the study was to develop the simpler method to treat the benign distal esophageal stenosis. Methods: Five benign distal esophageal stenosis cases were included in the study. A standard videogastroscope was inserted into the gastric antrum of the patient and then the gastroscope tip was deflected 210° and rotated it until the gastroscope tip adhered to the gastric minor curvature in the mid of the corpus above the angular incisure. While retained that position, the gastroscope was withdrew slowly until the endoscopist felt the resistant of the minor curvature gastric wall and the scope could not be withdrew anymore, however the withdrawal process was continued for a few more milimeters and kept that position for a few seconds. This maneuver dilated the distal esophageal stenosis. Results: All benign distal esophageal stenosis patients (case 1: female, 49 years old; case 2: male, 75 years old; case 3: female, 72 years old; case 4: female, 32 years old; case 5: male 55 years old) were successfully dilated. Three patients (case 1, 2, and 3) have been 7 months after first dilation without further deglutition problem. Case 4 was relapsed after 6 months and redilated successfully. Case 5 has been 4 months observation period after first dilation and without any deglutition problem. Conclusion: J-maneuver withdrawal method during gastroscopy looked promising method to dilate benign distal esophageal stenosis, which can be performed by basic endoscopists. Further studies are needed to determine to what extent this method can treat distal esophageal stenosis.

Published in International Journal of Gastroenterology (Volume 6, Issue 1)
DOI 10.11648/j.ijg.20220601.12
Page(s) 5-8
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

J-Maneuver Withdrawal Method, Gastroscopy, Benign Distal Esophageal Stenosis

References
[1] Luedtke P, Levine MS, Rubesin SE, et al. Radiologic Diagnosis of Benign Esophageal Strictures: A Pattern Approach. Radiographics 2003; 23: 897–909.
[2] Baron TH. Management of Benign Esophageal Strictures. Gastroenterol Hepatol 2011; 7: 47-49.
[3] Chuah SK, WU KL, Hu TH, et al. Endoscope-guided pneumatic dilation for treatment of esophageal achalasia, World J Gastroenterol 2010; 16: 411-417.
[4] Patel DA, Lappas BM, and Vaezi MF. An overview of achalasia and its subtypes. Gastroenterol & Hepatol 2017; 13: 411-421.
[5] Pandolfino JE and Gawron AJ. Achalasia, a systematic review. JAMA 2015; 313: 1841-1852.
[6] Nijhuis O, Zaninotto G, Roman S, et al. European guidelines on achalasia: United European Gastroenterology and European Society of Neurogastroenterology and Motility recommendations. United European Gastroenterology Journal 2020, Vol. 8 (1) 13–33.
[7] Ravich WJ. Endoscopic Management of Benign Esophageal Strictures. Curr Gastroenterol Rep 2017 Aug 24; 19 (10): 50. doi: 10.1007/s11894-017-0591-8.
[8] Fugazza A and Repici A. Endoscopic Management of Refractory Benign Esophageal Strictures. Dysphagia. 2021 Jun; 36 (3): 504-516. doi: 10.1007/s00455-021-10270-y.
[9] Vermeulen BD, de Zwart M, Sijben J, et al. Risk factors and clinical outcomes of endoscopic dilation in benign esophageal strictures: a long-term follow-up study. Gastrointest Endosc 2020; 91: 1058-66.
[10] Javed AT, Batte K, Khalaf M, et al. Durability of pneumatic dilation monotherapy in treatment-naive achalasia patients. BMC Gastroenterology 2019; 19: 181.
[11] Ofosu A, Mohan BP, Ichkhanian Y, et al. Peroral endoscopic myotomy (POEM) vs pneumatic dilation (PD) in treatment of achalasia: A meta-analysis of studies with ≥ 12-month follow-up. Endosc Int Open 2021; 09: E1097–E1107.
[12] Werner YB, Hakanson B, Martinek J, et al. Endoscopic or surgical myotomy in patients with idiopathic achalasia. N Engl J Med 2019; 381: 2219-29.
[13] Nabi Z, Ramchandani M, and Reddy N. Optional management of achalasia in 2021: dilatation or myotomy. J Digest Endosc 2021; 12: 93–102.
[14] Baron TH. Top tips for dilation of benign esophageal strictures. Gastrointest Endosc. 2022; 95: 562-564.
[15] Wang J, Zhao L, Wu R, et al. Appropriate duration of endoscopic dilation for postoperative benign esophageal strictures. Surg Endosc. 2022 Feb; 36 (2): 1263-1268. doi: 10.1007/s00464-021-08400-6.
Cite This Article
  • APA Style

    Putut Bayupurnama, Neneng Ratnasari, Catharina Triwikatmani, Fahmi Indrarti, Sutanto Maduseno. (2022). A Novel J-Maneuver Withdrawal Method During Gastroscopy to Dilate the Benign Distal Esophageal Stenosis. International Journal of Gastroenterology, 6(1), 5-8. https://doi.org/10.11648/j.ijg.20220601.12

    Copy | Download

    ACS Style

    Putut Bayupurnama; Neneng Ratnasari; Catharina Triwikatmani; Fahmi Indrarti; Sutanto Maduseno. A Novel J-Maneuver Withdrawal Method During Gastroscopy to Dilate the Benign Distal Esophageal Stenosis. Int. J. Gastroenterol. 2022, 6(1), 5-8. doi: 10.11648/j.ijg.20220601.12

    Copy | Download

    AMA Style

    Putut Bayupurnama, Neneng Ratnasari, Catharina Triwikatmani, Fahmi Indrarti, Sutanto Maduseno. A Novel J-Maneuver Withdrawal Method During Gastroscopy to Dilate the Benign Distal Esophageal Stenosis. Int J Gastroenterol. 2022;6(1):5-8. doi: 10.11648/j.ijg.20220601.12

    Copy | Download

  • @article{10.11648/j.ijg.20220601.12,
      author = {Putut Bayupurnama and Neneng Ratnasari and Catharina Triwikatmani and Fahmi Indrarti and Sutanto Maduseno},
      title = {A Novel J-Maneuver Withdrawal Method During Gastroscopy to Dilate the Benign Distal Esophageal Stenosis},
      journal = {International Journal of Gastroenterology},
      volume = {6},
      number = {1},
      pages = {5-8},
      doi = {10.11648/j.ijg.20220601.12},
      url = {https://doi.org/10.11648/j.ijg.20220601.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijg.20220601.12},
      abstract = {Background: Bouginage and pneumatic dilation are the first treatments for benign esophageal stenosis or stricture. Aim of the study was to develop the simpler method to treat the benign distal esophageal stenosis. Methods: Five benign distal esophageal stenosis cases were included in the study. A standard videogastroscope was inserted into the gastric antrum of the patient and then the gastroscope tip was deflected 210° and rotated it until the gastroscope tip adhered to the gastric minor curvature in the mid of the corpus above the angular incisure. While retained that position, the gastroscope was withdrew slowly until the endoscopist felt the resistant of the minor curvature gastric wall and the scope could not be withdrew anymore, however the withdrawal process was continued for a few more milimeters and kept that position for a few seconds. This maneuver dilated the distal esophageal stenosis. Results: All benign distal esophageal stenosis patients (case 1: female, 49 years old; case 2: male, 75 years old; case 3: female, 72 years old; case 4: female, 32 years old; case 5: male 55 years old) were successfully dilated. Three patients (case 1, 2, and 3) have been 7 months after first dilation without further deglutition problem. Case 4 was relapsed after 6 months and redilated successfully. Case 5 has been 4 months observation period after first dilation and without any deglutition problem. Conclusion: J-maneuver withdrawal method during gastroscopy looked promising method to dilate benign distal esophageal stenosis, which can be performed by basic endoscopists. Further studies are needed to determine to what extent this method can treat distal esophageal stenosis.},
     year = {2022}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - A Novel J-Maneuver Withdrawal Method During Gastroscopy to Dilate the Benign Distal Esophageal Stenosis
    AU  - Putut Bayupurnama
    AU  - Neneng Ratnasari
    AU  - Catharina Triwikatmani
    AU  - Fahmi Indrarti
    AU  - Sutanto Maduseno
    Y1  - 2022/03/31
    PY  - 2022
    N1  - https://doi.org/10.11648/j.ijg.20220601.12
    DO  - 10.11648/j.ijg.20220601.12
    T2  - International Journal of Gastroenterology
    JF  - International Journal of Gastroenterology
    JO  - International Journal of Gastroenterology
    SP  - 5
    EP  - 8
    PB  - Science Publishing Group
    SN  - 2640-169X
    UR  - https://doi.org/10.11648/j.ijg.20220601.12
    AB  - Background: Bouginage and pneumatic dilation are the first treatments for benign esophageal stenosis or stricture. Aim of the study was to develop the simpler method to treat the benign distal esophageal stenosis. Methods: Five benign distal esophageal stenosis cases were included in the study. A standard videogastroscope was inserted into the gastric antrum of the patient and then the gastroscope tip was deflected 210° and rotated it until the gastroscope tip adhered to the gastric minor curvature in the mid of the corpus above the angular incisure. While retained that position, the gastroscope was withdrew slowly until the endoscopist felt the resistant of the minor curvature gastric wall and the scope could not be withdrew anymore, however the withdrawal process was continued for a few more milimeters and kept that position for a few seconds. This maneuver dilated the distal esophageal stenosis. Results: All benign distal esophageal stenosis patients (case 1: female, 49 years old; case 2: male, 75 years old; case 3: female, 72 years old; case 4: female, 32 years old; case 5: male 55 years old) were successfully dilated. Three patients (case 1, 2, and 3) have been 7 months after first dilation without further deglutition problem. Case 4 was relapsed after 6 months and redilated successfully. Case 5 has been 4 months observation period after first dilation and without any deglutition problem. Conclusion: J-maneuver withdrawal method during gastroscopy looked promising method to dilate benign distal esophageal stenosis, which can be performed by basic endoscopists. Further studies are needed to determine to what extent this method can treat distal esophageal stenosis.
    VL  - 6
    IS  - 1
    ER  - 

    Copy | Download

Author Information
  • Division of Gastroenterology & Hepatology, Department of Internal Medicine, Dr. Sardjito General Hospital, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia

  • Division of Gastroenterology & Hepatology, Department of Internal Medicine, Dr. Sardjito General Hospital, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia

  • Division of Gastroenterology & Hepatology, Department of Internal Medicine, Dr. Sardjito General Hospital, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia

  • Division of Gastroenterology & Hepatology, Department of Internal Medicine, Dr. Sardjito General Hospital, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia

  • Division of Gastroenterology & Hepatology, Department of Internal Medicine, Dr. Sardjito General Hospital, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia

  • Sections