A first-of-its-kind a Giant Polypoidal Esophageal (food pipe)Tumour measuring of 8 cm X 2.5 cm was removed with the help of Endoscopy & Endoscopy Ultrasound (EUS) by Dr Vipulroy Rathod

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MUMBAI, July 10, 2013: In what could be the first-of-its-kind surgery in India, a Mumbai-based Gastroenterologist Consultant, Dr Vipulroy Rathod, Endoscopic Surgeon and Director, Endoscopy Asia successfully performed a rare case of Endoscopic Removal of a Giant Polypoidal Lesion from Esophagus (food pipe) recently.

The patient was suffering with dysphagia (difficulty in swallowing) and severe chest pain off and on for more than two months. After undergoing several barium tests, endoscopies, CT scans and MRIs, he was advised surgical intervention either in the form of Thoracoscopy or Thoracotomy as the only measure to excise his tumour by several experts from India. However, Endoscopic treatment option was not considered before the patient met Dr Rathod.

“This is the first ever case of its kind in India and may be the world, which has enabled us to give a new lease of life to Hitesh Gupta (name changed on request) by removing a 8 cm x 2.5 cm tumour from his esophagus (food pipe)  with the help of Endoscopy and Endoscopy Ultrasound (EUS),” says Dr Rathod.

On Endoscopy and Endoscopic Ultrasound (EUS) evaluation by Dr. Vipulroy Rathod, it appeared to him that an endoscopic treatment option can be considered in this case and hence all the pros and cons of such an option were discussed with the patient and the relatives.

“We have seen several cases of polypoidal tumours in the stomach, duodenum, and colon and have been successfully treated with Endoscopy & Endoscopy Ultrasound (EUS), however such a giant polypoidal tumour of this size 8.0 cms x 2.5 cms, with a 2 cms thick stalk in the esophagus was observed for the first time”, says Dr. Rathod, Pioneer of Endoscopic Ultrasound (EUS) and Interventional Pancreato-Biliary EUS in India and who has performed more than 17000 EUS Procedures till date which is the largest individual experience in India.

“I did not want to undergo massive open surgeries, which would have left me with lifelong disability along with heavy scars on my body”, says 37 year old Mr. Hitesh Gupta. (Name changed on request). “I was extremely disappointed and lost hope that I can ever get cured without a supramajor surgical intervention, till I met Dr. Rathod. He advised me Endoscopic Procedure for removal of my tumour. The thought of a surgery without a single scar made me instantly ready for the procedure,” the patient further said.

This resection was carried out in two sessions and the entire tumour was successfully resected from the stalk.  There was no blood loss and the tumour was delivered from the mouth. The histopathological examination confirmed that it was a benign stromal tumour.

In the above case, if the patient would have undergone a Thoracoscopic Surgical option, Dr. Rathod felt that there was a possibility, that he would have ended up in a thoracotomy and esophageal resection anastomosis as the tumor was not in the layers of the esophageal wall but hanging in the lumen of the esophagus. An open surgery would have probably caused prolonged recovery and patient would not have felt normal ever.

Endoscopy is the most accurate form of diagnosis for early detection of cancers of Gastrointestinal Tract. Endoscopic Ultrasound (EUS) helps in accurate staging of cancers. Endoscopy can also offer safe and quick form of treatment as well. Endoscopic treatments reduce the morbidity that usually comes with conventional surgeries, and are also cost effective and time saving as they are mostly done on an OPD basis.

In case of Mr. Hitesh Gupta, after the removal of the lesion he was given oral food within next 24 hrs and was discharged after 48 hrs after the endoscopic surgery. This was possible as there was absolutely no blood loss, patient did not require blood transfusions or ICU admission as the endoscopic treatment was without any complications.


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