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Erschienen in: Dysphagia 3/2021

12.03.2021 | Review

Endoscopic Management of Refractory Benign Esophageal Strictures

verfasst von: Alessandro Fugazza, Alessandro Repici

Erschienen in: Dysphagia | Ausgabe 3/2021

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Abstract

Benign esophageal strictures are commonly encountered in clinical practice. The principal etiologies of benign esophageal strictures include long term acid reflux, caustic injuries, eosinophilic esophagitis, anastomotic strictures or endoscopic therapy. Dysphagia is most prominently present in esophageal strictures along with a variety of other symptoms which depend on the stricture etiology. Benign esophageal strictures can be categorized into two groups: simple or complex depending on their structure. Most strictures can be treated successfully with endoscopic dilation by bougies or balloons dilators. In some cases, treatment is more challenging, involving a higher risk of the patient developing recurrent or refractory strictures. To improve symptoms in these patients, other endoscopic treatments such as steroid injection, incisional therapy and stent placement should be considered. In this manuscript, we provide a comprehensive review of the main treatment options currently available to manage recurrent benign esophageal strictures.
Literatur
7.
Zurück zum Zitat Beg S, Ragunath K, Wyman A, Banks M, Trudgill N, Pritchard DM, Riley S, Anderson J, Griffiths H, Bhandari P, Kaye P, Veitch A. Quality standards in upper gastrointestinal endoscopy: a position statement of the British Society of Gastroenterology (BSG) and Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland (AUGIS). Gut. 2017;66(11):1886–99. https://doi.org/10.1136/gutjnl-2017-314109.CrossRefPubMed Beg S, Ragunath K, Wyman A, Banks M, Trudgill N, Pritchard DM, Riley S, Anderson J, Griffiths H, Bhandari P, Kaye P, Veitch A. Quality standards in upper gastrointestinal endoscopy: a position statement of the British Society of Gastroenterology (BSG) and Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland (AUGIS). Gut. 2017;66(11):1886–99. https://​doi.​org/​10.​1136/​gutjnl-2017-314109.CrossRefPubMed
9.
Zurück zum Zitat Weusten B, Bisschops R, Coron E, Dinis-Ribeiro M, Dumonceau JM, Esteban JM, Hassan C, Pech O, Repici A, Bergman J, di Pietro M. Endoscopic management of Barrett’s esophagus: European Society of Gastrointestinal Endoscopy (ESGE) position statement. Endoscopy. 2017;49(2):191–8. https://doi.org/10.1055/s-0042-122140.CrossRefPubMed Weusten B, Bisschops R, Coron E, Dinis-Ribeiro M, Dumonceau JM, Esteban JM, Hassan C, Pech O, Repici A, Bergman J, di Pietro M. Endoscopic management of Barrett’s esophagus: European Society of Gastrointestinal Endoscopy (ESGE) position statement. Endoscopy. 2017;49(2):191–8. https://​doi.​org/​10.​1055/​s-0042-122140.CrossRefPubMed
20.
Zurück zum Zitat Vermeulen BD, de Zwart M, Sijben J, Soons E, van der Weerd L, Arese D, von den Hoff DW, Craviotto V, Tan A, Groenen MJM, Bogte A, Repici A, Spaander MCW, Siersema PD. Risk factors and clinical outcomes of endoscopic dilation in benign esophageal strictures: a long-term follow-up study. Gastrointest Endosc. 2020;91(5):1058–66. https://doi.org/10.1016/j.gie.2019.12.040.CrossRefPubMed Vermeulen BD, de Zwart M, Sijben J, Soons E, van der Weerd L, Arese D, von den Hoff DW, Craviotto V, Tan A, Groenen MJM, Bogte A, Repici A, Spaander MCW, Siersema PD. Risk factors and clinical outcomes of endoscopic dilation in benign esophageal strictures: a long-term follow-up study. Gastrointest Endosc. 2020;91(5):1058–66. https://​doi.​org/​10.​1016/​j.​gie.​2019.​12.​040.CrossRefPubMed
29.
Zurück zum Zitat Ashcraft KW, Holder TM. The expeimental treatment of esophageal strictures by intralesional steroid injections. J Thorac Cardiovasc Surg. 1969;58(5):685–91.CrossRefPubMed Ashcraft KW, Holder TM. The expeimental treatment of esophageal strictures by intralesional steroid injections. J Thorac Cardiovasc Surg. 1969;58(5):685–91.CrossRefPubMed
31.
Zurück zum Zitat Hirdes MM, van Hooft JE, Koornstra JJ, Timmer R, Leenders M, Weersma RK, Weusten BL, van Hillegersberg R, van Berge Henegouwen MI, Plukker JT, Wiezer R, Bergman JG, Vleggaar FP, Fockens P, Siersema PD. Endoscopic corticosteroid injections do not reduce dysphagia after endoscopic dilation therapy in patients with benign esophagogastric anastomotic strictures. Clin Gastroenterol Hepatol. 2013;11(7):795–801. https://doi.org/10.1016/j.cgh.2013.01.016.CrossRefPubMed Hirdes MM, van Hooft JE, Koornstra JJ, Timmer R, Leenders M, Weersma RK, Weusten BL, van Hillegersberg R, van Berge Henegouwen MI, Plukker JT, Wiezer R, Bergman JG, Vleggaar FP, Fockens P, Siersema PD. Endoscopic corticosteroid injections do not reduce dysphagia after endoscopic dilation therapy in patients with benign esophagogastric anastomotic strictures. Clin Gastroenterol Hepatol. 2013;11(7):795–801. https://​doi.​org/​10.​1016/​j.​cgh.​2013.​01.​016.CrossRefPubMed
33.
Zurück zum Zitat Yang J, Wang X, Li Y, Lu G, Lu X, Guo D, Wang W, Liu C, Xiao Y, Han N, He S. Efficacy and safety of steroid in the prevention of esophageal stricture after endoscopic submucosal dissection: a network meta-analysis. J Gastroenterol Hepatol. 2019;34(6):985–95. https://doi.org/10.1111/jgh.14580.CrossRefPubMed Yang J, Wang X, Li Y, Lu G, Lu X, Guo D, Wang W, Liu C, Xiao Y, Han N, He S. Efficacy and safety of steroid in the prevention of esophageal stricture after endoscopic submucosal dissection: a network meta-analysis. J Gastroenterol Hepatol. 2019;34(6):985–95. https://​doi.​org/​10.​1111/​jgh.​14580.CrossRefPubMed
34.
Zurück zum Zitat Dasari CS, Jegadeesan R, Patel HK, Desai M, Aziz M, Thoguluvachandrasekar V, Duvvuri A, Kohli DR, Repici A, Siersema PD, Sharma P. Intralesional steroids and endoscopic dilation for anastomotic strictures after esophagectomy: systematic review and meta-analysis. Endoscopy. 2020;52(9):721–6. https://doi.org/10.1055/a-1172-5975.CrossRefPubMed Dasari CS, Jegadeesan R, Patel HK, Desai M, Aziz M, Thoguluvachandrasekar V, Duvvuri A, Kohli DR, Repici A, Siersema PD, Sharma P. Intralesional steroids and endoscopic dilation for anastomotic strictures after esophagectomy: systematic review and meta-analysis. Endoscopy. 2020;52(9):721–6. https://​doi.​org/​10.​1055/​a-1172-5975.CrossRefPubMed
49.
Zurück zum Zitat Hagiwara A, Togawa T, Yamasaki J, Shirasu M, Sakakura C, Yamagishi H. Endoscopic incision and balloon dilatation for cicatricial anastomotic strictures. Hepatogastroenterology. 1999;46(26):997–9.PubMed Hagiwara A, Togawa T, Yamasaki J, Shirasu M, Sakakura C, Yamagishi H. Endoscopic incision and balloon dilatation for cicatricial anastomotic strictures. Hepatogastroenterology. 1999;46(26):997–9.PubMed
50.
Zurück zum Zitat Mangiavillano B, Auriemma F, Bianchetti M, Mantovani N, Pilati S, Reggio D, Barletti C, Forcignano E, Pentassuglia G, Arezzo A, Cavargini E, Fabbri C, Mezzanzanica M, De Luca L, Conigliaro R, Repici A. Through-the-scope esophageal stent for the relief of malignant dysphagia: results of a multicentric study (with video). Dig Endosc. 2020. https://doi.org/10.1111/den.13704.CrossRefPubMed Mangiavillano B, Auriemma F, Bianchetti M, Mantovani N, Pilati S, Reggio D, Barletti C, Forcignano E, Pentassuglia G, Arezzo A, Cavargini E, Fabbri C, Mezzanzanica M, De Luca L, Conigliaro R, Repici A. Through-the-scope esophageal stent for the relief of malignant dysphagia: results of a multicentric study (with video). Dig Endosc. 2020. https://​doi.​org/​10.​1111/​den.​13704.CrossRefPubMed
51.
Zurück zum Zitat Anderloni A, Genco C, Massidda M, Di Leo M, Fumagalli UR, Rosati R, Correale L, Maselli R, Ferrara EC, Jovani M, Repici A. Self-expanding metal stents for the treatment of post-surgical esophageal leaks: a tertiary referral center experience. Dig Surg. 2019;36(4):309–16. https://doi.org/10.1159/000489817.CrossRefPubMed Anderloni A, Genco C, Massidda M, Di Leo M, Fumagalli UR, Rosati R, Correale L, Maselli R, Ferrara EC, Jovani M, Repici A. Self-expanding metal stents for the treatment of post-surgical esophageal leaks: a tertiary referral center experience. Dig Surg. 2019;36(4):309–16. https://​doi.​org/​10.​1159/​000489817.CrossRefPubMed
54.
Zurück zum Zitat Spaander MC, Baron TH, Siersema PD, Fuccio L, Schumacher B, Escorsell A, Garcia-Pagan JC, Dumonceau JM, Conio M, de Ceglie A, Skowronek J, Nordsmark M, Seufferlein T, Van Gossum A, Hassan C, Repici A, Bruno MJ. Esophageal stenting for benign and malignant disease: European Society of Gastrointestinal Endoscopy (ESGE) clinical guideline. Endoscopy. 2016;48(10):939–48. https://doi.org/10.1055/s-0042-114210.CrossRefPubMed Spaander MC, Baron TH, Siersema PD, Fuccio L, Schumacher B, Escorsell A, Garcia-Pagan JC, Dumonceau JM, Conio M, de Ceglie A, Skowronek J, Nordsmark M, Seufferlein T, Van Gossum A, Hassan C, Repici A, Bruno MJ. Esophageal stenting for benign and malignant disease: European Society of Gastrointestinal Endoscopy (ESGE) clinical guideline. Endoscopy. 2016;48(10):939–48. https://​doi.​org/​10.​1055/​s-0042-114210.CrossRefPubMed
59.
Zurück zum Zitat Walter D, van den Berg MW, Hirdes MM, Vleggaar FP, Repici A, Deprez PH, Viedma BL, Lovat LB, Weusten BL, Bisschops R, Haidry R, Ferrara E, Sanborn KJ, O’Leary EE, van Hooft JE, Siersema PD. Dilation or biodegradable stent placement for recurrent benign esophageal strictures: a randomized controlled trial. Endoscopy. 2018;50(12):1146–55. https://doi.org/10.1055/a-0602-4169.CrossRefPubMed Walter D, van den Berg MW, Hirdes MM, Vleggaar FP, Repici A, Deprez PH, Viedma BL, Lovat LB, Weusten BL, Bisschops R, Haidry R, Ferrara E, Sanborn KJ, O’Leary EE, van Hooft JE, Siersema PD. Dilation or biodegradable stent placement for recurrent benign esophageal strictures: a randomized controlled trial. Endoscopy. 2018;50(12):1146–55. https://​doi.​org/​10.​1055/​a-0602-4169.CrossRefPubMed
62.
Zurück zum Zitat Fugazza A, Sethi A, Trindade AJ, Troncone E, Devlin J, Khashab MA, Vleggaar FP, Bogte A, Tarantino I, Deprez PH, Fabbri C, Aparicio JR, Fockens P, Voermans RP, Uwe W, Vanbiervliet G, Charachon A, Packey CD, Benias PC, El-Sherif Y, Paiji C, Ligresti D, Binda C, Martinez B, Correale L, Adler DG, Repici A, Anderloni A. International multicenter comprehensive analysis of adverse events associated with lumen-apposing metal stent placement for pancreatic fluid collection drainage. Gastrointest Endosc. 2020;91(3):574–83. https://doi.org/10.1016/j.gie.2019.11.021.CrossRefPubMed Fugazza A, Sethi A, Trindade AJ, Troncone E, Devlin J, Khashab MA, Vleggaar FP, Bogte A, Tarantino I, Deprez PH, Fabbri C, Aparicio JR, Fockens P, Voermans RP, Uwe W, Vanbiervliet G, Charachon A, Packey CD, Benias PC, El-Sherif Y, Paiji C, Ligresti D, Binda C, Martinez B, Correale L, Adler DG, Repici A, Anderloni A. International multicenter comprehensive analysis of adverse events associated with lumen-apposing metal stent placement for pancreatic fluid collection drainage. Gastrointest Endosc. 2020;91(3):574–83. https://​doi.​org/​10.​1016/​j.​gie.​2019.​11.​021.CrossRefPubMed
67.
Zurück zum Zitat Mohan BP, Chandan S, Garg R, Mohamed S, Shakhatreh M, Dugyala S, Mashiana HS, Ponnada S, Asokkumar R, Adler DG. Lumen-apposing metal stents, fully covered self-expanding metal stents, and biodegradable stents in the management of benign of GI strictures: a systematic review and meta-analysis. J Clin Gastroenterol. 2019;53(8):560–73. https://doi.org/10.1097/MCG.0000000000001228.CrossRefPubMed Mohan BP, Chandan S, Garg R, Mohamed S, Shakhatreh M, Dugyala S, Mashiana HS, Ponnada S, Asokkumar R, Adler DG. Lumen-apposing metal stents, fully covered self-expanding metal stents, and biodegradable stents in the management of benign of GI strictures: a systematic review and meta-analysis. J Clin Gastroenterol. 2019;53(8):560–73. https://​doi.​org/​10.​1097/​MCG.​0000000000001228​.CrossRefPubMed
70.
Zurück zum Zitat Thomson M, Tringali A, Dumonceau JM, Tavares M, Tabbers MM, Furlano R, Spaander M, Hassan C, Tzvinikos C, Ijsselstijn H, Viala J, Dall’Oglio L, Benninga M, Orel R, Vandenplas Y, Keil R, Romano C, Brownstone E, Hlava S, Gerner P, Dolak W, Landi R, Huber WD, Everett S, Vecsei A, Aabakken L, Amil-Dias J, Zambelli A. Paediatric gastrointestinal endoscopy: European society for paediatric gastroenterology hepatology and nutrition and european society of gastrointestinal endoscopy guidelines. J Pediatr Gastroenterol Nutr. 2017;64(1):133–53. https://doi.org/10.1097/MPG.0000000000001408.CrossRefPubMed Thomson M, Tringali A, Dumonceau JM, Tavares M, Tabbers MM, Furlano R, Spaander M, Hassan C, Tzvinikos C, Ijsselstijn H, Viala J, Dall’Oglio L, Benninga M, Orel R, Vandenplas Y, Keil R, Romano C, Brownstone E, Hlava S, Gerner P, Dolak W, Landi R, Huber WD, Everett S, Vecsei A, Aabakken L, Amil-Dias J, Zambelli A. Paediatric gastrointestinal endoscopy: European society for paediatric gastroenterology hepatology and nutrition and european society of gastrointestinal endoscopy guidelines. J Pediatr Gastroenterol Nutr. 2017;64(1):133–53. https://​doi.​org/​10.​1097/​MPG.​0000000000001408​.CrossRefPubMed
89.
Zurück zum Zitat Committee ASoP, Khashab MA, Chithadi KV, Acosta RD, Bruining DH, Chandrasekhara V, Eloubeidi MA, Fanelli RD, Faulx AL, Fonkalsrud L, Lightdale JR, Muthusamy VR, Pasha SF, Saltzman JR, Shaukat A, Wang A, Cash BD. Antibiotic prophylaxis for GI endoscopy. Gastrointest Endosc. 2015;81(1):81–9. https://doi.org/10.1016/j.gie.2014.08.008.CrossRef Committee ASoP, Khashab MA, Chithadi KV, Acosta RD, Bruining DH, Chandrasekhara V, Eloubeidi MA, Fanelli RD, Faulx AL, Fonkalsrud L, Lightdale JR, Muthusamy VR, Pasha SF, Saltzman JR, Shaukat A, Wang A, Cash BD. Antibiotic prophylaxis for GI endoscopy. Gastrointest Endosc. 2015;81(1):81–9. https://​doi.​org/​10.​1016/​j.​gie.​2014.​08.​008.CrossRef
91.
Zurück zum Zitat Siersema PD. Management of refractory benign esophageal strictures. Gastroenterol Hepatol (N Y). 2018;14(3):189–91. Siersema PD. Management of refractory benign esophageal strictures. Gastroenterol Hepatol (N Y). 2018;14(3):189–91.
Metadaten
Titel
Endoscopic Management of Refractory Benign Esophageal Strictures
verfasst von
Alessandro Fugazza
Alessandro Repici
Publikationsdatum
12.03.2021
Verlag
Springer US
Erschienen in
Dysphagia / Ausgabe 3/2021
Print ISSN: 0179-051X
Elektronische ISSN: 1432-0460
DOI
https://doi.org/10.1007/s00455-021-10270-y

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