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Magnetic compression for treatment of large oesophageal diverticula: a new endoscopic approach for a risky surgical disease?
  1. Simon Bouchard1,2,
  2. Vincent Huberty1,2,
  3. Daniel Blero1,
  4. Jacques Devière1,2
  1. 1Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Erasme Hospital, Université libre de Bruxelles, Brussels, Belgium
  2. 2Laboratory of Experimental Gastroenterology, Université Libre de Bruxelles (ULB), Brussels, Belgium
  1. Correspondence to Professor Jacques Devière, Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Erasme Hospital, Université Libre de Bruxelles, 808 route de Lennik, Brussels 1070, Belgium, jacques.deviere{at}erasme.ulb.ac.be

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Magnetic compression resulting in serosa-to-serosa apposition followed by pressure necrosis has been shown to be able to create solid anastomostic connections and has been reported in conditions such as oesophageal atresia, benign biliary strictures and malignant gastric outlet obstruction. This first series evaluated this technique for the management of large intrathoracic oesophageal diverticula by creating a communication between the bottom of the diverticulum and the distal oesophagus followed, in a second endoscopy session, by the transection of the proximal septum. Four patients underwent this procedure without complications and with excellent clinical outcome, suggesting that this might be a very promising endoscopic approach avoiding surgery in these difficult cases (figure 1).

Figure 1

(A) Fluoroscopic view of a gastroscope advanced to the level of a large lower oesophageal diverticulum. (B) Endoscopic view after placement of two magnets, with one magnet at the base of the diverticulum and the other at the opposite side of the septum, in the oesophagus. (C) Ten days following their endoscopic placement, the magnets have joined together, have migrated into the diverticulum and have been removed. The magnet-induced anastomosis between the diverticulum and the oesophagus is clearly visualised. (D) A control gastroscopy is performed 24 h after completion of the …

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