Liu Ping, Ren Jianzhuang, Han Xinwei, Guo Changqing, Bi Yonghua
Department of Gastroenterology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, China.
Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, No.1, East Jian She Road, Zhengzhou, 450052, China.
Sci Rep. 2025 Mar 29;15(1):10843. doi: 10.1038/s41598-025-95627-1.
Benign esophageal strictures (BES) have been usually treated with balloon dilatation with occasionally drug-coated balloon (DCB) or large balloon dilatation. We compared the clinical outcomes of 3 types of dilatations: small balloon dilatation, DCB dilatation, and large balloon dilatation for the treatment of BES. This retrospective study evaluated 3 groups of 82 consecutive patients with BES who underwent dilatation of either small balloon (Group S, n = 25), DCB (Group D, n = 22) or large balloon (Group L, n = 35). Technical success, dysphagia score, safety and recurrence of stricture were collected and evaluated. Technical success rates of dilatation procedure were 88.7%, 87.1% and 89.7% in Group S, Group D and Group L, respectively (P = 0.9291). Rupture occurred in 8 dilatations: two (2.8%) in the Group S, one (3.2%) in the Group D and 5 (7.4%) in the Group L (P = 0.4109). The final scores in Group L (0.4 ± 0.9) was significantly lower than that in Group S (1.3 ± 1.5) or Group D (1.3 ± 1.4; P < 0.01). A total of 44/82 patients (53.7%) were cured with no dysphagia after the end of follow-up: 10 (40.0%) in the Group S, 9 (40.9%) in the Group D and 25 (71.4%) in the Group L. Group L showed the best clinical effectiveness among the three groups (P = 0.0272). Longer hospitalization was required in the Group D (median 21.0, interquartile range [IQR] 10.0-49.5) than in the Group S (median 14.0, IQR 9.0-24.0) or the Group L (median 12.0, IQR 8.0-24.0, P = 0.0112). More hospitalization cost was required in the Group D (median 6.9 months, IQR 3.7-11.2 months) than in the Group S (median 4.0 months, IQR 2.6-6.8 months) or the Group L (median 3.1, IQR 2.1-6.3, P = 0.0006). In conclusion, large balloon dilatation is a safe and effective treatment for BES, with higher clinical effectiveness, shorter hospitalization and lower hospitalization cost. The use of DCB seems least preferable, as they are associated with more hospitalization cost and few cases of clinical improvement.
良性食管狭窄（BES）通常采用球囊扩张术治疗，偶尔也会使用药物涂层球囊（DCB）或大型球囊扩张术。我们比较了三种扩张术治疗BES的临床疗效：小型球囊扩张术、DCB扩张术和大型球囊扩张术。这项回顾性研究评估了连续接受小型球囊（S组，n = 25）、DCB（D组，n = 22）或大型球囊（L组，n = 35）扩张术的82例BES患者。收集并评估了技术成功率、吞咽困难评分、安全性和狭窄复发情况。S组、D组和L组扩张术的技术成功率分别为88.7%、87.1%和89.7%（P = 0.9291）。8次扩张术中发生破裂：S组2例（2.8%），D组1例（3.2%），L组5例（7.4%）（P = 0.4109）。L组的最终评分（0.4±0.9）显著低于S组（1.3±1.5）或D组（1.3±1.4；P < 0.01）。82例患者中有44例（53.7%）在随访结束后治愈且无吞咽困难：S组10例（40.0%），D组9例（40.9%），L组25例（71.4%）。L组在三组中临床疗效最佳（P = 0.0272）。D组住院时间（中位数21.0，四分位数间距[IQR] 10.0 - 49.5）比S组（中位数14.0，IQR 9.0 - 24.0）或L组（中位数12.0，IQR 8.0 - 24.0，P = 0.0112）更长。D组住院费用（中位数6.9个月，IQR 3.7 - 11.2个月）比S组（中位数4.0个月，IQR 2.6 - 6.8个月）或L组（中位数3.1，IQR 2.1 - 6.3，P = 0.0006）更高。总之，大型球囊扩张术是治疗BES的一种安全有效的方法，具有更高的临床疗效、更短的住院时间和更低的住院费用。DCB的使用似乎最不理想，因为它们与更高的住院费用和较少的临床改善病例相关。
