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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).
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