Reply to the letter by A.C. Leong and D.B. Mitchell on “Endoscopic management of oesophageal food bolus obstruction: flexibility is the way forward”

Abstract

Sir, In reply to the letter by A.C. Leong and D.B. Mitchell [1], the Wrst point raised concerns the two case series published recently on endoscopic disimpaction of food boluses using Xexible endoscopes. These two papers were published long after the review was completed but despite this, they do not add anything to what is already known on the subject, i.e. that Xexible endoscopes can be used to successfully disimpact food boluses wherever they occur in the oesophagus. With regard to the other points, we would agree that Xexible endoscopy is probably safer for removing none sharp food boluses and made this point in the review. It would seem as if Xexible endoscopy is becoming more acceptable as a Wrst line in treatment of these cases, but this is certainly not the norm, as indicated by our Wndings in the e-mail survey. We feel that with the increased use of and availability of TNFLO scopes in ENT departments, the days of the rigid scope are certainly numbered and there will be very few indications for its use in the future [2]. The gastroenterologists just might Wnd themselves with less work to do as the oesophagus becomes the territory of the ENT surgeon.