Endoscopic incision and selective cutting for primary treatment of benign esophageal anastomotic stricture: outcomes of 5 cases with a minimum follow-up of 12 months

Ann Palliat Med. 2020 May;9(3):1206-1210. doi: 10.21037/apm-20-1090.

Abstract

Background: Benign anastomotic esophageal stricture after surgical resection frequently occurs and requires endoscopic balloon dilation (EBD) or incision to maintain patency because of the significant recurrence rate. Our study was designed to evaluate the effectiveness and safety of endoscopic incision and selective cutting (EISC) as primary treatment on 5 patients for benign anastomotic esophageal stricture.

Methods: Five patients with benign stricture of the esophageal anastomosis after radical resection for esophageal cancer underwent EISC in our center between April, 2018 and January, 2019. The effectiveness and safety of the procedure were observed during at least 12 months follow-up.

Results: The EISC was successfully performed in all 5 patients. The diameters of the anastomoses were increased from 1-3 preoperatively to 14-18 mm (mean: 15.6 mm) intraoperatively (P<0.05). The duration of the operation ranged from 30-55 min (mean: 42.8 min). During at least 12 months follow-up observations, all patients resumed eating solid meals and had no recurrence of dysphagia.

Conclusions: EISC as primary treatment is a safe and effective treatment for benign anastomotic esophageal stricture.

Keywords: Endoscopic incision and selective cutting (EISC); dysphagia; esophageal anastomotic stricture.

MeSH terms

  • Anastomosis, Surgical
  • Constriction, Pathologic
  • Esophageal Stenosis* / etiology
  • Esophageal Stenosis* / surgery
  • Follow-Up Studies
  • Humans
  • Neoplasm Recurrence, Local
  • Retrospective Studies
  • Treatment Outcome