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Appropriate duration of endoscopic dilation for postoperative benign esophageal strictures

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Abstract

Background

Benign esophageal strictures are a frequent complication after esophageal surgery or extensive endoscopic submucosal dissection. Endoscopic dilation is the preferred treatment in clinical practice. However, the allocation of time for each dilation is unclear. The aim of this study was to evaluate the appropriate duration of endoscopic dilation for benign esophageal strictures after esophageal surgery or endoscopic submucosal dissection.

Methods

Patients with benign esophageal strictures after esophageal surgery or endoscopic submucosal dissection between July 2010 and July 2018 were retrospectively included in this study. According to the dilation time (1, 3, 5 min), patients were divided into three groups. The clinical effects and adverse events were compared among the three groups.

Results

Altogether, 57 patients, including 21 in the 1-min group, 18 in the 3-min group and 18 in the 5-min group, were included. All patients underwent endoscopic treatment successfully. The stricture recurrence rate was 76.19% in the 1-min group, 55.56% in the 3-min group and 61.11% in the 5-min group. The median overall dysphagia-free period was 2.60 (range, 0.80–12.00) months in the 1-min group, 6.60 (range, 1.80–12.00) months in the 3-min group and 6.25 (range, 2.40–12.00) months in the 5-min group (P < 0.05). For patients who developed stricture recurrence, the mean dysphagia-free periods were 2.26  ±  1.27 months, 4.00  ±  1.76 months and 4.23  ±  1.63 months, respectively (P < 0.05). The dysphagia-free periods were comparable between the 3- and 5-min groups and were longer than those in the 1-min group. Muscle layer damage occurred in two patients (11.11%) in the 5-min group and in no patients in the other two groups.

Conclusion

Three minutes was considered a safe and effective dilation duration for benign esophageal strictures after esophageal surgery or endoscopic submucosal dissection.

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Authors and Affiliations

  1. Digestive Endoscopy Department and General Surgery Department, The First Affiliated Hospital With Nanjing Medical University and Jiangsu Province Hospital, 300 Guangzhou Road, Nanjing, Jiangsu Province, China

    Jiankun Wang, Lili Zhao, Rui Wu, Min Wang, Li Liu, Xiang Wang, Wenjie Liu, Kexin He & Zhining Fan

  2. Gastroenterology Department, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China

    Lin Miao

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  1. Jiankun Wang
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  2. Lili Zhao
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  3. Rui Wu
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  4. Min Wang
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  5. Li Liu
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  6. Xiang Wang
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  8. Kexin He
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  9. Lin Miao
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  10. Zhining Fan
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Correspondence to Zhining Fan.

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Disclosures

Drs. Jiankun Wang, Lili Zhao, Rui Wu, Min Wang, Li Liu, Xiang Wang, Wenjie Liu, Kexin He, Lin Miao and Zhining Fan declare that they have no conflicts of interest or financial ties to disclose.

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Wang, J., Zhao, L., Wu, R. et al. Appropriate duration of endoscopic dilation for postoperative benign esophageal strictures. Surg Endosc 36, 1263–1268 (2022). https://doi.org/10.1007/s00464-021-08400-6

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  • DOI: https://doi.org/10.1007/s00464-021-08400-6

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