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Effective diameter of balloon dilation for benign esophagojejunal anastomotic stricture after total gastrectomy

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Abstract

Background

Benign strictures at esophagojejunostomy sites may develop after total gastrectomy, and through-the-scope balloon dilation (TTS-BD) can relieve them. The aim of this study was to evaluate effective and safe balloon diameter for benign stricture after total gastrectomy.

Methods

From June 2001 to December 2006, 930 gastric cancer patients underwent total gastrectomy with Roux-en-Y esophagojejunostomy in a cancer center hospital. We performed TTS-BD when benign strictures developed. Initial success rate, complication rate, and restenosis rate were evaluated. We classified the patients into three groups according to final dilation diameter and number of sessions.

Results

A total of 58 patients (6.2%) developed a benign stricture at the esophagojejunostomy site. We classified them into three groups based on the final luminal diameter of the balloon used and the number of sessions, as follows: group A (n = 20), 13.5–15 mm in one or two sessions; group B (n = 13), 16.5–20 mm in one session; group C (n = 25), 16.5–20 mm in two sessions. The initial success rates were 100% for groups A and B and 96% for group C. A perforation occurred in one patient (7.7%) in group B. Restenosis occurred in two patients (10%) in group A, one patient (7.7%) in group B, and in no patients in group C (p = 0.29). Restenosis was resolved by one or two further TTS-BDs.

Conclusion

TTS-BD to 15 mm was a safe and effective treatment for benign esophagojejunostomy strictures following total gastrectomy. Restenosis was not common and could be resolved by one or two further TTS-BD sessions.

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Acknowledgment

This work was partially supported by grant 0610080 from the National Cancer Center, Korea.

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Authors and Affiliations

  1. Research Institute and Hospital, National Cancer Center, Goyang, Korea

    Chan Gyoo Kim, Il Ju Choi, Jong Yeul Lee, Soo-Jeong Cho, Jun Ho Lee, Keun Won Ryu, Sook Ryun Park & Young-Woo Kim

  2. Center for Gastric Cancer, National Cancer Center, 809 Madu 1-dong, Ilsandong-gu, Goyang, Gyeonggi, 411-769, Korea

    Il Ju Choi

  3. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

    Jae-Moon Bae

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  1. Chan Gyoo Kim
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  2. Il Ju Choi
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Correspondence to Il Ju Choi.

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Kim, C.G., Choi, I.J., Lee, J.Y. et al. Effective diameter of balloon dilation for benign esophagojejunal anastomotic stricture after total gastrectomy. Surg Endosc 23, 1775–1780 (2009). https://doi.org/10.1007/s00464-008-0224-2

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  • DOI: https://doi.org/10.1007/s00464-008-0224-2

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