Benign anastomotic strictures after esophagectomy: Long-term effectiveness of balloon dilation and factors affecting recurrence in 155 patients

Ju Yang Park, Ho Young Song, Jin Hyoung Kim, Jung Hoon Park, Han Kyu Na, Yong Hee Kim, Seung Il Park

Research output: Contribution to journalArticlepeer-review

23 Scopus citations

Abstract

OBJECTIVE. The purpose of this article is to retrospectively evaluate the long-term clinical results of balloon dilation in the treatment of benign anastomotic strictures after esophagectomy and to identify factors associated with stricture recurrence. MATERIALS AND METHODS. From January 1996 to June 2011, a total of 309 sessions of balloon dilation were performed in 155 patients with benign anastomotic strictures after esophagectomy. Long-term clinical effectiveness was assessed using the following variables: technical and clinical success, complications, and patency rates. Factors independently related to recurrence were evaluated with the Cox model. Tested variables were age, sex, operation type, postoperative anastomotic leakage, balloon size, length of stricture, time to postoperative stricture development, complications, and neoadjuvant chemoradiotherapy. RESULTS. The mean follow-up period was 37 months (range, 1-159 months). Overall clinical success was achieved in 153 patients (99%) after a single (n = 78) or multiple (n = 75) balloon dilations. During follow-up, recurrence of the stricture requiring repeated dilation was seen in 77 of 155 patients (50%). Esophageal rupture (mostly intramural rupture) occurred in 22 of 155 patients (14%) and 34 of 309 balloon dilations (11%). In multivariate analysis, early development of stricture within 10 weeks after surgery (p = 0.002) and McKeown esophagectomy (p = 0.002) were independently related to recurrence after initial balloon dilation. CONCLUSION. Balloon dilation under fluoroscopic guidance has encouraging longterm results in the treatment of benign anastomotic strictures after esophagectomy. However, recurrence after balloon dilation was common, with McKeown esophagectomy and development of stricture within 10 weeks after surgery associated with recurrent strictures.

Original languageEnglish (US)
Pages (from-to)1208-1213
Number of pages6
JournalAmerican Journal of Roentgenology
Volume198
Issue number5
DOIs
StatePublished - May 2012
Externally publishedYes

Keywords

  • Balloon dilation
  • Benign anastomotic stricture
  • Esophagectomy

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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