Endoscopic Dilation of Benign Post-Esophagectomy Anastomotic Strictures: Long Term Outcomes and Risk of Recurrence

Aims Esophageal anastomotic strictures often require repeat dilation to relieve dysphagia. Little is known about factors that affect their remediation. The purpose of this article is to retrospectively evaluate the long-term clinical results of endoscopic dilation in the treatment of benign anastomotic strictures after esophagectomy and to identify factors associated with stricture recurrence.

Methods A single-center retrospective analysis (using electronic records) was performed on patients who underwent endoscopic dilation for anastomotic esophageal stenosis. Long-term clinical effectiveness including technical and clinical success and complications rate was assessed. Factors independently related to recurrence were evaluated.

Results Between January 2014 and December 2017, a total of 35 patients who had benign anastomotic stricture after esophagectomy underwent 182 endoscopic dilatation procedures. Of the 35 patients, 91 % had initial relief of dysphagia. The final clinical success rate was achieved in 24 patients (69 %). The stricture recurred in 43 % of patients, and refractory strictures were identified in 10/35 (29 %). Proximal anastomosis and the presence of anastomotic foreign bodies were found to be risk factors for refractory strictures. Complications rate was low (4 %) and adverse events were mild. No major complications (perforations, severe bleeding) or treatment-related deaths occurred in this series.

Conclusions Fluoroscopically endoscopic Savary-Gilliard mechanical dilation is a well-standardized and a technically easy modality for the treatment of benign anastomotic stricture after esophagectomy. The procedure has an excellent technical success rate, a low complication rate and good clinical success rate. Yet, anastomotic strictures require frequent dilation sessions and carry a high recurrence rate. Many anastomotic strictures are refractory to endoscopic dilation.

Citation: Badir M, Hag E, Abu Asbeh Y et al. eP52 ENDOSCOPIC DILATION OF BENIGN POST-ESOPHAGECTOMY ANASTOMOTIC STRICTURES: LONG TERM OUTCOMES AND RISK OF RECURRENCE. Endoscopy 2021; 53: S113.

Publication History

Article published online:
19 March 2021