Yan Junjun, Liao Qiangming, Ding Bin
Jiujiang City Key Laboratory of Cell Therapy, Department of Gastroenterology, The First People's Hospital of Jiujiang City, Jiujiang, China.
Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Gastroenterology, Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China.
Front Med (Lausanne). 2025 Jul 2;12:1540103. doi: 10.3389/fmed.2025.1540103. eCollection 2025.
The endoscopic treatment of complete esophageal stricture presents a huge challenge. In instances where the esophageal lumen is nearly obliterated, preventing the passage of a dilating guide wire, conventional endoscopic bougie dilation is often difficult to perform. We report a case of patients with nearly complete esophageal stricture due to esophageal cancer surgery, leading to severe dysphagia and weight loss. Our strategy began with the achievement of anterograde esophageal access, facilitated by a biliary intubation method and aided by a 0.35-inch guidewire. Subsequently, we sequentially applied biliary dilators and balloon dilators, progressing along the guidewire to incrementally dilate the esophageal lumen up to the site of complete stenosis. The stenosis was successfully penetrated and dilated, and eventually the patient's dysphagia was completely relieved. This case underscores the efficacy of the novel endoscopic treatment for biliary appendices in patients with refractory esophageal anastomotic stricture, offering a new therapeutic approach for clinical management.
完全性食管狭窄的内镜治疗是一项巨大挑战。在食管腔几乎闭塞、无法通过扩张导丝的情况下，传统的内镜探条扩张术往往难以实施。我们报告一例因食管癌手术导致几乎完全性食管狭窄的患者，患者出现严重吞咽困难和体重减轻。我们的策略首先是通过胆道插管法实现顺行性食管通路，并借助一根0.35英寸的导丝辅助。随后，我们沿导丝依次应用胆道扩张器和球囊扩张器，逐步扩张食管腔直至完全狭窄部位。成功穿透并扩张了狭窄部位，最终患者的吞咽困难完全缓解。该病例强调了新型内镜治疗对难治性食管吻合口狭窄患者的疗效，为临床管理提供了一种新的治疗方法。
