Traversing Difficult Esophageal Strictures from the Retrograde Approach

Esophageal strictures are common and are categorized as simple or complex. Complex strictures are long, severely narrowed, angulated and/or are irregular. In this article we discuss the management challenge that complex strictures pose. Some complex strictures may require a transgastric (retrograde) approach for safe and effective endoscopic management. For complete esophageal obstruction caused by a complex stricture, an antegrade-retrograde rendezvous technique using fluoroscopic guidance and careful dissection can provide successful non-operative esophageal recanalization.