title: Endoscopic membranectomy with a high-frequency-wave snare/cutter for membranous stenosis in the upper gastrointestinal tract.
abstract: OBJECTIVE
  As endoscopic equipment and instruments have been improved, the indication for endoscopic surgery has been extended. The authors achieved endoscopic membranectomy for congenital membranous stenosis in the upper gastrointestinal tract.
  
  
  METHODS
  Case 1 was a 3-year-old girl with membranous stenosis in the descending duodenum. Case 2 was a 1-year-old boy with esophageal membranous stenosis. In case 1, a flexible endoscope with a banding chamber, the inside of which had a tiny groove for a high-frequency-wave snare, was inserted into the duodenum. The diaphragm was drawn into the chamber by endoscopic suction and tied with the snare around its base, then dissected by electrifying the snare. In case 2, the diaphragm was resected with a high-frequency-wave cutter, assisted by a balloon catheter pulling up the diaphragm from the distal side.
  
  
  RESULTS
  In both cases, the stenosis was released adequately without complications, and oral feeding was restarted in a day after the procedure.
  
  
  CONCLUSIONS
  Endoscopic membranectomy using a high-frequency wave snare/cutter was achieved safely and effectively in 2 children with congenital membranous stenosis in the upper gastrointestinal tract.
authors.affiliation: Department of Pediatric Surgery, Osaka Medical Center for Maternal and Child Health, Izumi, Osaka 594-1101, Japan.
authors.forename: Satoko
authors.initials: S
authors.lastname: Nose
authors.forename: Akio
authors.initials: A
authors.lastname: Kubota
authors.forename: Hisayoshi
authors.initials: H
authors.lastname: Kawahara
authors.forename: Hiroomi
authors.initials: H
authors.lastname: Okuyama
authors.forename: Takaharu
authors.initials: T
authors.lastname: Oue
authors.forename: Yuko
authors.initials: Y
authors.lastname: Tazuke
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Ihara
authors.forename: Akira
authors.initials: A
authors.lastname: Okada
mesh_terms: D002675:Child, Preschool; D003251:Constriction, Pathologic; D004378:Duodenal Diseases / Q000601:surgery*; D019723:Endoscopes; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D004940:Esophageal Stenosis / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D016634:Radiosurgery / Q000379:methods*; D016896:Treatment Outcome