THELDENIYA TECHNIQUE OF ENDOSCOPIC THERMO-ABLATION (TETA) FOR ESOPHAGEAL CANCER kosala.medi@gmail.com

311-03

THELDENIYA TECHNIQUE OF ENDOSCOPIC THERMO-ABLATION (TETA) FOR ESOPHAGEAL CANCER

2

Sri Lanka

Oral or Poster

This new technique was devised to alleviate dysphagia in a) patients on palliation who are not amenable to stents due to very tight stricture b) patients who refuses surgery and other oncologic treatments c) patients in the work up, awaiting surgery

Malignant tissues were ablated using the endoscopic hot biopsy forceps keeping diathermy in SoftCoag 90watt settings. Channel is coagulated through the obstructing tumor. All patients were scored as per Functional Oral Intake scale (FIOS), pre-TETA and post-TETA. FIOS score 1-7, 1-total dysphagia. 7-no dysphagia, Patients who were on palliation were stented using covered stents after achieving adequate channel diameter

From July/2024 to July/2025 fourteen (14) patients underwent TETA. 11 on palliative pathway and 03 on pre-op work-up. All patients climbed at least two points in FIOS scale after TETA One patient remarkably climbed from 01 to 07 (i.e. from total dysphagia to no dysphagia at all). No patient had any esophageal perforation. Two patients underwent laparo-thoracoscopic esophagectomy (both without neo-adjuvant chemo-radiation as decided in MDT). Interestingly one patient had surgical specimen histology negative for malignancy, possibly pointing to TETA having a therapeutic value as well. This particular result if supported by further evaluations would be a possible breakthrough in the management of esophageal cancer.

TETA achieved good relief from dysphagia both in therapeutic and palliative settings in patients who were not amenable to esophageal stenting. There are early indications towards possible therapeutic value of TETA, which needs further evaluation.