Choi Cheol Woong, Kang Dae Hwan, Kim Hyung Wook, Park Su Bum, Kim Su Jin, Nam Hyeong Seok, Ryu Dae Gon
Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea.
Korean J Gastroenterol. 2017 Feb 25;69(2):102-108. doi: 10.4166/kjg.2017.69.2.102.
BACKGROUND/AIMS: Benign esophageal stricture after esophagectomy is not an infrequent complication. Anastomotic esophageal stricture requires frequent multiple dilations. We aimed to evaluate the clinical outcomes of dilation therapies using an endoscopic balloon or bougie dilator and analyzed the risk factors associated with refractory stricture.
Between January 2009 and May 2016, the medical records of 21 patients treated with endoscopic balloon dilation or bougie dilation for esophageal anastomotic strictures were retrospectively reviewed.
During the study periods, a total of 21 patients were diagnosed with esophageal anastomotic stricture and included for analysis (17 male; mean age, 68.2±7.2 years at the first procedure). The mean stricture length was 6.4±8.1 mm. The refractory stricture was found in 28.6% of patients, and successful relief of dysphagia was achieved in 71.4% of patients. The major complication associated with dilations was absent. Factors associated with refractory stricture were stricture length (> 10 mm, p<0.049) and diabetes mellitus (p=0.035). Additive bougie dilations achieved clinical success in 4 out of 7 patients.
Dilation with endoscopic balloon or bougie dilator was an effective and safe procedure for benign anastomotic esophageal strictures of less than 10 mm in length.
背景/目的：食管切除术后良性食管狭窄是一种常见并发症。吻合口食管狭窄需要频繁进行多次扩张。我们旨在评估使用内镜球囊或探条扩张器进行扩张治疗的临床效果，并分析与难治性狭窄相关的危险因素。
回顾性分析2009年1月至2016年5月期间21例接受内镜球囊扩张或探条扩张治疗食管吻合口狭窄患者的病历。
在研究期间，共有21例患者被诊断为食管吻合口狭窄并纳入分析（17例男性；首次治疗时平均年龄为68.2±7.2岁）。平均狭窄长度为6.4±8.1毫米。28.6%的患者出现难治性狭窄，71.4%的患者吞咽困难得到成功缓解。未出现与扩张相关的主要并发症。与难治性狭窄相关的因素为狭窄长度（>10毫米，p<0.049）和糖尿病（p=0.035）。7例患者中有4例通过追加探条扩张取得了临床成功。
对于长度小于10毫米的良性吻合口食管狭窄，使用内镜球囊或探条扩张器进行扩张是一种有效且安全的方法。
