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. 2021 Aug 9;26(1):e125-e131.
doi: 10.1055/s-0041-1726049. eCollection 2022 Jan.

Oncologic Panendoscopy: Description of an Optimized Procedure Based on Our Experience

Laurence Pincet  1 , Cécile de Sandre  1 , Florian J W Lang  2 , Victor Colin  2
Affiliations

Oncologic Panendoscopy: Description of an Optimized Procedure Based on Our Experience

Laurence Pincet et al. Int Arch Otorhinolaryngol. .

Abstract

Introduction All patients with a new head and neck squamous cell carcinoma (HNSCC) undergo diagnostic panendoscopy as part of the screening for synchronous second primary tumors. It includes a pharyngolaryngoscopy (PLS), a tracheobronchoscopy and esophagoscopy, and a stomatoscopy. Rigid techniques are risky, with long learning curves. Objective We propose a precise description of the panendoscopy protocol. We include an optimization of the PLS technique that completes the flexible esophagoscopy when rigid esophagoscopy isn't performed. Methods The present retrospective observational study includes 122 consecutive patients with a new primary HNSCC who underwent traditional panendoscopy and the new PLS technique between January 2014 and December 2016. A two-step procedure using a Macintosh laryngoscope and a 30° telescope first exposes panoramically the larynx, the upper trachea, and the oropharynx; then, in a second step, the hypopharynx is exposed down to the upper esophageal sphincter. Broncho-esophagoscopy is performed with a rigid and flexible scope. Results In total, 6 (5%) patients presented synchronous tumors (3 in the esophagus, 2 in the oral cavity, and 1 in the larynx 1). Rigid endoscopy was complicated by 2 (1,6%) dental lesions, and had to be completed with a flexible scope in 38 (33%) cases for exposition reasons. The two-step PLS offered a wide-angle view of the larynx, upper trachea, and oro- and hypopharynx down to the sphincter of the upper esophagus. The procedure was easy, reliable, safe, repeatable, and effectively completed the flexible endoscopies. Conclusion Rigid esophagoscopy remains a difficult procedure. Two-step PLS combined with flexible broncho-esophagoscopy offers good optical control.

Keywords: cancer screening test; esophagoscopic surgical procedure; multiple primary neoplasms; squamous cell carcinoma; synchronous; synchronous neoplasms.

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Conflict of interest statement

Conflict of Interests The authors have no conflict of interests to declare.

Figures

Fig. 1
Fig. 1
First step of the panendoscopy.
Fig. 2
Fig. 2
Second step of the panendoscopy.
Fig. 3
Fig. 3
Comparison between rigid and flexible esophagoscopy. ( A, B ): flexible esophagoscopy with the narrow-band imaging mode ( B ). ( C,D ) Rigid esophagoscopy with the narrow-band imaging mode ( D ).
See this image and copyright information in PMC

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