Original articleClinical endoscopyPrimary incisional therapy with a modified method for patients with benign anastomotic esophageal stricture
Section snippets
Patients
This study was designed as a prospective outcome study in endoscopy follow-up. From May 2005 until December 2007, a total of 24 patients who had developed anastomotic stricture after esophagojejunostomy were observed. The eligibility criteria for benign anastomotic stricture excluded etiologically peptic, corrosive-induced, radiation-induced, drug-induced, or malignant strictures. All patients had undergone surgical treatment for gastric and esophageal cancer (18 and 6 patients, respectively).
Results
The length of stricture was less than 1 cm for 21 of 24 patients (87.5%) and more than 1 cm for 3 of 24 patients (12.5%). Postoperative complications and whether or not staplers were used were not statistically significantly related to the length of stricture. Both the Iso-Tome (16 patients) and IT-knife (8 patients) were used according to the same methodology. In all patients, dilation of the strictures was successfully performed in a single treatment session, without any immediate
Discussion
The occurrence of benign anastomotic esophageal stricture after surgical resection is not uncommon. However, a significant rate of recurrence is problematic, and no one dilation method has proven to be superior. In various studies, the median number of dilation sessions varied between 2 and 9 per patient.1, 2, 3, 5, 11, 12 With these considerations in mind, electrocautery therapy has been proposed. In a study by Hordijk et al,14 20 patients with fibrotic anastomotic esophageal stenosis were
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DISCLOSURE: All authors disclosed no financial relationships relevant to this publication.
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