Magnet and wire remodeling for the treatment of candy cane syndrome: first case series of a new approach (with video)

Rio-Tinto, Ricardo; Huberland, François; Ouytsel, Pauline Van; Delattre, Cécilia; Dugardeyn, Sonia; Cauche, Nicolas; Delchambre, Alain; Devière, Jacques; Bléro, Daniel

doi:10.1016/j.gie.2021.12.027

Cited by 4 publications

(3 citation statements)

References 15 publications

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“…[1][2][3][4] An endoscopic approach to the treatment of CCS using active magnets and slow incisions has been described with excellent medium-term success. [9] However, long term results are not yet available with this promising technique.…”

Section: Discussionmentioning

confidence: 99%

“…Anecdotal cases of CCS treatment with a lumen-apposing stent (n = 1) or suturing devices (n = 2) have been reported and we recently reported medium-term results of a pilot series using active magnets for afferent loop marsupialization [6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Endoscopic marsupialization for severe candy cane syndrome: long-term follow-up

et al. 2022

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Candy cane syndrome (CCS) is a clinical condition that may occur after gastrectomy or gastric bypass, when an excessively long or mispositioned blind jejunal loop proximal to the anastomosis is left in place. Preferential food passage in this loop results in symptoms such as fullness, pain, reflux, regurgitation, and postprandial vomiting. Surgical resection of the dilated loop is technically complex, and morbidity limits its use in fragile patients. An endoscopic approach, using dedicated active magnets, has recently been shown to be effective in the medium-term. We present here the case of a 71-year-old female patient who underwent endoscopic treatment for the first time. She presented with intractable vomiting, food intolerance, and cachexia due to CCS after total gastrectomy for gastric cancer. Surgical treatment was not an option in such a high-risk patient, and she accepted treatment with a novel endoscopic approach using a double-magnet device followed by septotomy to marsupialize the blind loop. Her symptoms were completely resolved, and she regained weight. We report here her clinical outcomes at 3 years, suggesting that endoscopic marsupialization for CCS is not only effective in the short term but also provides long-term clinical benefit.

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