Department of Interventional Radiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Medicine (Baltimore). 2023 Aug 25;102(34):e34766. doi: 10.1097/MD.0000000000034766.
Surgical resection of esophageal cancer may result in benign anastomotic strictures, which are usually treated by balloon dilatation. Here we reported the long-term outcomes of large balloon dilatation for benign anastomotic strictures secondary to esophagectomy for esophageal cancer. From February 2011 to December 2016, 27 esophageal cancer patients underwent large balloon dilatation for benign strictures following surgical resection. Clinical success rate, number of dilatation sessions, complication rate, and mortality rate were evaluated. A total of 27 patients developed a benign stricture at the esophagectomy site. A total of 50 dilatation sessions of large balloon were performed, with a mean of 1.8 sessions per patients (range 1.0-5.0). Only 1 perforation was observed (2.0% per dilatation session), and required no surgery. No procedure-related deaths were recorded. Large balloon dilation was technically successful in the remained 26 patients (96.3%). Dysphagia score and stricture index decreased significantly (P < .0001). Proximal diameter of stricture, stricture diameter and length decreased significantly. Patients were followed up for 36.3 ± 7.1 months, and 14 patients survived without dysphagia. The survival rates were 95.0%, 69.1%, 34.5% for 1, 5, and 9 years, respectively. The median survival was 96.0 months. Large balloon dilatation can be a safe and feasible treatment for benign anastomic strictures following surgical resection of esophageal cancer, with a low perforation rate. However, further study compared with small balloon dilatation is warranted.
食管癌手术后吻合口良性狭窄可能需要通过球囊扩张来治疗。本研究报道了大球囊扩张治疗食管癌手术后吻合口良性狭窄的长期疗效。2011 年 2 月至 2016 年 12 月，27 例食管癌患者因外科切除术后吻合口良性狭窄而行大球囊扩张。评估了临床成功率、扩张次数、并发症发生率和死亡率。共 27 例患者在食管癌切除术后吻合口发生良性狭窄。共进行了 50 次大球囊扩张，平均每个患者进行 1.8 次扩张（范围 1.0-5.0 次）。仅观察到 1 例穿孔（每次扩张的发生率为 2.0%），无需手术。无与手术相关的死亡病例。26 例（96.3%）患者大球囊扩张技术成功。吞咽困难评分和狭窄指数显著降低（P<.0001）。狭窄近端直径、狭窄直径和长度显著减小。患者平均随访 36.3±7.1 个月，14 例患者无吞咽困难且存活。1、5、9 年的生存率分别为 95.0%、69.1%和 34.5%。中位生存时间为 96.0 个月。大球囊扩张治疗食管癌术后吻合口良性狭窄是一种安全可行的方法，穿孔率低。但需要进一步与小球囊扩张进行比较研究。
