Endoscopic Treatment of Postoperative Esophageal Anastomotic Strictures: A Single Center Experience

Abstract

Background To evaluate the analysis, treatment methods and results of endoscopic treatments of esophagojejunostomy (EJ) and esophagogastric (EG) anastomotic strictures. Methods: Data from patients treated between 2009 and 2019 was collected and analyzed. The primary endpoint was defined as the absence of dysphagia for at least 6 months after the final endoscopic treatment session. The improvement in dysphagia scores at 1 and 6 months was accepted as the secondary endpoint. Results Of 18 patients (10 male), there were 11 patients with EG anastomotic stricture and 7 patients with EJ anastomotic stricture. Only balloon or bougie dilatation was applied to 13 patients, while 5 patients received a full-covered metal stent (FCMS) in addition to balloon or bougie dilatation due to persistent dysphagia symptoms. The primary endpoint was reached in 10 of the 13 patients (76.9%) who received only balloon or bougie dilatation. The secondary endpoint was reached in 3 patients. The primary endpoint was reached in 4 of the 5 patients (80%) who received a FCMS in addition to balloon or bougie dilatation. 6 patients (33.3%) had a recurrence. Major complications occurred in 4 (22.2%) patients, including perforation in 2 and stent migration in 2 patients. Conclusion The study demonstrated that endoscopic treatment of esophageal anastomotic strictures is a reliable and effective treatment option with a high success rate. The use of FCMS, either as a primary treatment option or in the treatment of perforation as a complication of endoscopic treatment, showed good effectiveness in our study.