Outcomes of balloon dilation for the treatment of strictures after endoscopic submucosal dissection compared with peptic strictures

Surg Endosc. 2013 Sep;27(9):3237-46. doi: 10.1007/s00464-013-2900-0. Epub 2013 Mar 12.

Abstract

Background: The outcomes of balloon dilation for the treatment of strictures caused by endoscopic submucosal dissection (ESD) have not been evaluated previously. This study was designed to evaluate and compare the effectiveness and complications of balloon dilation for post-ESD strictures and peptic strictures.

Methods: The medical records of 14 patients with post-ESD strictures and 48 patients with peptic strictures who underwent fluoroscopically or endoscopically guided balloon dilation between January 1997 and April 2011 at the Asan Medical Center in Korea were reviewed retrospectively.

Results: The technical success rates (defined as successful dilation without major complications) of the post-ESD and peptic stricture groups were 92.9% (13/14) and 93.8% (45/48), respectively (p = 1.000). For the post-ESD and peptic stricture groups, the clinical success rates (defined as symptom improvement, as determined by the patient) at 1 month were 92.9% (13/14) and 83.3% (40/48), respectively (p = 0.67). Their clinical success rates at 6 months were 71.4% (10/14) and 70 % (28/40), respectively (p = 1.000). The mean weight gains of the post-ESD stricture group 1 and 6 months after balloon dilation were 1.1 and 4.8 kg, respectively, whereas the peptic group gained 1.4 and 3.4 kg, respectively (p = 0.814). All complications were perforations. The complication rates of the post-ESD and peptic stricture groups were 7.1 % (1/14) and 10.5 % (5/48), respectively (p = 1.000).

Conclusions: Balloon dilation is an effective and safe treatment for post-ESD strictures.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Constriction, Pathologic / etiology
  • Constriction, Pathologic / therapy
  • Contrast Media
  • Dissection / adverse effects*
  • Endoscopy, Gastrointestinal / adverse effects*
  • Female
  • Fluoroscopy
  • Gastrointestinal Diseases / etiology*
  • Gastrointestinal Diseases / surgery*
  • Humans
  • Iohexol / analogs & derivatives
  • Male
  • Middle Aged
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Contrast Media
  • Iohexol
  • iopromide