Non-Reflux-Mediated Esophageal Strictures

  • Sajiv Sethi
  • Joel E. RichterEmail author


Strictures are a common disease of the esophagus that develop from a variety of underlying etiologies and are classified as complex or simple strictures. While a variety of endoscopic therapies exist, esophageal dilation is the mainstay of treatment in these patients. Differences exist in the characteristics of various strictures which can affect their management and prognosis. Several options for dilation exist and careful selection of the type of dilator and technique is important. The choice of therapy must be individualized for each patient and is based on the underlying etiology and anatomy of the stricture. This article aims to review the types of esophageal dilators, methods of dilation, and the management of all types of non-peptic esophageal strictures.


Esophageal dilation Strictures Schatzki ring Esophageal web Refractory strictures Post-ablative strictures Eosinophilic esophagitis Postoperative strictures Anastomotic strictures Radiation-induced strictures Rule of three 


  1. 1.
    Ravich WJ. Endoscopic management of benign esophageal strictures. Curr Gastroenterol Rep. 2017;19(10):50.PubMedCrossRefGoogle Scholar
  2. 2.
    Sami SS, Haboubi HN, Ang Y, et al. UK guidelines on oesophageal dilatation in clinical practice. Gut. 2018;67(6):1000–23.PubMedPubMedCentralCrossRefGoogle Scholar
  3. 3.
    van Boeckel PG, Siersema PD. Refractory esophageal strictures: what to do when dilation fails. Curr Treat Options Gastroenterol. 2015;13(1):47–58.PubMedPubMedCentralCrossRefGoogle Scholar
  4. 4.
    Richter JE. Rule of three for esophageal dilation: like the tortoise versus the rabbit, low and slow is our friend and our patients’ win. Gastrointest Endosc. 2017;85(2):338–9.PubMedCrossRefGoogle Scholar
  5. 5.
    Pereira-Lima JC, Ramires RP, Zamin I Jr, Cassal AP, Marroni CA, Mattos AA. Endoscopic dilation of benign esophageal strictures: report on 1043 procedures. Am J Gastroenterol. 1999;94(6):1497–501.PubMedCrossRefGoogle Scholar
  6. 6.
    Kochman ML, McClave SA, Boyce HW. The refractory and the recurrent esophageal stricture: a definition. Gastrointest Endosc. 2005;62(3):474–5.PubMedCrossRefGoogle Scholar
  7. 7.
    Saeed ZA, Winchester CB, Ferro PS, Michaletz PA, Schwartz JT, Graham DY. Prospective randomized comparison of polyvinyl bougies and through-the-scope balloons for dilation of peptic strictures of the esophagus. Gastrointest Endosc. 1995;41(3):189–95.PubMedCrossRefGoogle Scholar
  8. 8.
    Scolapio JS, Pasha TM, Gostout CJ, et al. A randomized prospective study comparing rigid to balloon dilators for benign esophageal strictures and rings. Gastrointest Endosc. 1999;50(1):13–7.PubMedCrossRefGoogle Scholar
  9. 9.
    Boyce HW Jr. Precepts of safe esophageal dilation. Gastrointest Endosc. 1977;23(4):215.PubMedCrossRefGoogle Scholar
  10. 10.
    Tulman AB, Boyce HW Jr. Complications of esophageal dilation and guidelines for their prevention. Gastrointest Endosc. 1981;27(4):229–34.PubMedCrossRefGoogle Scholar
  11. 11.
    Standards of Practice C, Egan JV, Baron TH, et al. Esophageal dilation. Gastrointest Endosc. 2006;63(6):755–60.CrossRefGoogle Scholar
  12. 12.
    Grooteman KV, Wong Kee Song LM, Vleggaar FP, Siersema PD, Baron TH. Non-adherence to the rule of 3 does not increase the risk of adverse events in esophageal dilation. Gastrointest Endosc. 2017;85(2):332–7. e331.PubMedCrossRefGoogle Scholar
  13. 13.
    Benites Goni HE, Arcana Lopez R, Bustamante Robles KY, et al. Factors associated with complications during endoscopic esophageal dilation. Rev Esp Enferm Dig. 2018;110(7):440–5.PubMedGoogle Scholar
  14. 14.
    Williams RB, Grehan MJ, Hersch M, Andre J, Cook IJ. Biomechanics, diagnosis, and treatment outcome in inflammatory myopathy presenting as oropharyngeal dysphagia. Gut. 2003;52(4):471–8.PubMedPubMedCentralCrossRefGoogle Scholar
  15. 15.
    Wang AY, Kadkade R, Kahrilas PJ, Hirano I. Effectiveness of esophageal dilation for symptomatic cricopharyngeal bar. Gastrointest Endosc. 2005;61(1):148–52.PubMedCrossRefGoogle Scholar
  16. 16.
    Katzka DA, Smyrk TC, Bruce AJ, Romero Y, Alexander JA, Murray JA. Variations in presentations of esophageal involvement in lichen planus. Clin Gastroenterol Hepatol. 2010;8(9):777–82.PubMedCrossRefGoogle Scholar
  17. 17.
    Fox LP, Lightdale CJ, Grossman ME. Lichen planus of the esophagus: what dermatologists need to know. J Am Acad Dermatol. 2011;65(1):175–83.PubMedCrossRefGoogle Scholar
  18. 18.
    Eisen D. The clinical features, malignant potential, and systemic associations of oral lichen planus: a study of 723 patients. J Am Acad Dermatol. 2002;46(2):207–14.PubMedCrossRefGoogle Scholar
  19. 19.
    Rao B, Gulati A, Jobe B, Thakkar S. Esophageal lichen planus: understanding a potentially severe stricturing disease. Case Rep Gastrointest Med. 2017;2017:5480562.PubMedPubMedCentralGoogle Scholar
  20. 20.
    Goyal RK, Bauer JL, Spiro HM. The nature and location of lower esophageal ring. N Engl J Med. 1971;284(21):1175–80.PubMedCrossRefGoogle Scholar
  21. 21.
    Kramer P. Frequency of the asymptomatic lower esophageal contractile ring. N Engl J Med. 1956;254(15):692–4.PubMedCrossRefGoogle Scholar
  22. 22.
    Patel B, Han E, Swan K. Richard Schatzki: a familiar ring. AJR Am J Roentgenol. 2013;201(5):W678–82.PubMedCrossRefGoogle Scholar
  23. 23.
    Muller M, Gockel I, Hedwig P, et al. Is the Schatzki ring a unique esophageal entity? World J Gastroenterol. 2011;17(23):2838–43.PubMedPubMedCentralGoogle Scholar
  24. 24.
    Sgouros SN, Vlachogiannakos J, Karamanolis G, et al. Long-term acid suppressive therapy may prevent the relapse of lower esophageal (Schatzki’s) rings: a prospective, randomized, placebo-controlled study. Am J Gastroenterol. 2005;100(9):1929–34.PubMedCrossRefGoogle Scholar
  25. 25.
    Novak SH, Shortsleeve MJ, Kantrowitz PA. Effective treatment of symptomatic lower esophageal (Schatzki) rings with acid suppression therapy: confirmed on barium esophagography. AJR Am J Roentgenol. 2015;205(6):1182–7.PubMedCrossRefGoogle Scholar
  26. 26.
    Eckardt VF, Kanzler G, Willems D. Single dilation of symptomatic Schatzki rings. A prospective evaluation of its effectiveness. Dig Dis Sci. 1992;37(4):577–82.PubMedCrossRefGoogle Scholar
  27. 27.
    Ibrahim A, Cole RA, Qureshi WA, et al. Schatzki’s ring: to cut or break an unresolved problem. Dig Dis Sci. 2004;49(3):379–83.PubMedCrossRefGoogle Scholar
  28. 28.
    Wills JC, Hilden K, Disario JA, Fang JC. A randomized, prospective trial of electrosurgical incision followed by rabeprazole versus bougie dilation followed by rabeprazole of symptomatic esophageal (Schatzki’s) rings. Gastrointest Endosc. 2008;67(6):808–13.PubMedCrossRefGoogle Scholar
  29. 29.
    DiSario JA, Pedersen PJ, Bichis-Canoutas C, Alder SC, Fang JC. Incision of recurrent distal esophageal (Schatzki) ring after dilation. Gastrointest Endosc. 2002;56(2):244–8.PubMedCrossRefGoogle Scholar
  30. 30.
    Gonzalez A, Sullivan MF, Bonder A, Allison HV, Bonis PA, Guelrud M. Obliteration of symptomatic Schatzki rings with jumbo biopsy forceps (with video). Dis Esophagus. 2014;27(7):607–10.PubMedCrossRefGoogle Scholar
  31. 31.
    Hirose T, Funasaka K, Furukawa K, et al. A case of Plummer-Vinson syndrome with esophageal web formation in which detailed endoscopic images were obtained. Intern Med. 2019; 58:785–9.PubMedCrossRefGoogle Scholar
  32. 32.
    Katada C, Muto M, Manabe T, Boku N, Ohtsu A, Yoshida S. Esophageal stenosis after endoscopic mucosal resection of superficial esophageal lesions. Gastrointest Endosc. 2003;57(2):165–9.PubMedCrossRefGoogle Scholar
  33. 33.
    Mizuta H, Nishimori I, Kuratani Y, Higashidani Y, Kohsaki T, Onishi S. Predictive factors for esophageal stenosis after endoscopic submucosal dissection for superficial esophageal cancer. Dis Esophagus. 2009;22(7):626–31.PubMedCrossRefPubMedCentralGoogle Scholar
  34. 34.
    Isomoto H, Yamaguchi N, Minami H, Nakao K. Management of complications associated with endoscopic submucosal dissection/endoscopic mucosal resection for esophageal cancer. Dig Endosc. 2013;25(Suppl 1):29–38.PubMedCrossRefGoogle Scholar
  35. 35.
    Pouw RE, Seewald S, Gondrie JJ, et al. Stepwise radical endoscopic resection for eradication of Barrett’s oesophagus with early neoplasia in a cohort of 169 patients. Gut. 2010;59(9):1169–77.CrossRefGoogle Scholar
  36. 36.
    Takahashi H, Arimura Y, Okahara S, et al. Risk of perforation during dilation for esophageal strictures after endoscopic resection in patients with early squamous cell carcinoma. Endoscopy. 2011;43(3):184–9.PubMedCrossRefPubMedCentralGoogle Scholar
  37. 37.
    Yoda Y, Yano T, Kaneko K, et al. Endoscopic balloon dilatation for benign fibrotic strictures after curative nonsurgical treatment for esophageal cancer. Surg Endosc. 2012;26(10):2877–83.PubMedCrossRefGoogle Scholar
  38. 38.
    Takahashi H, Arimura Y, Okahara S, et al. A randomized controlled trial of endoscopic steroid injection for prophylaxis of esophageal stenoses after extensive endoscopic submucosal dissection. BMC Gastroenterol. 2015;15:1.PubMedPubMedCentralCrossRefGoogle Scholar
  39. 39.
    Sato H, Inoue H, Kobayashi Y, et al. Control of severe strictures after circumferential endoscopic submucosal dissection for esophageal carcinoma: oral steroid therapy with balloon dilation or balloon dilation alone. Gastrointest Endosc. 2013;78(2):250–7.PubMedCrossRefGoogle Scholar
  40. 40.
    Yamaguchi N, Isomoto H, Shikuwa S, et al. Effect of oral prednisolone on esophageal stricture after complete circular endoscopic submucosal dissection for superficial esophageal squamous cell carcinoma: a case report. Digestion. 2011;83(4):291–5.PubMedCrossRefGoogle Scholar
  41. 41.
    Shaheen NJ, Falk GW, Iyer PG, Gerson LB, American College of G. ACG clinical guideline: diagnosis and management of Barrett’s esophagus. Am J Gastroenterol. 2016;111(1):30–50; quiz 51.PubMedCrossRefGoogle Scholar
  42. 42.
    Overholt BF, Lightdale CJ, Wang KK, et al. Photodynamic therapy with porfimer sodium for ablation of high-grade dysplasia in Barrett’s esophagus: international, partially blinded, randomized phase III trial. Gastrointest Endosc. 2005;62(4):488–98.PubMedCrossRefGoogle Scholar
  43. 43.
    Shaheen NJ, Sharma P, Overholt BF, et al. Radiofrequency ablation in Barrett’s esophagus with dysplasia. N Engl J Med. 2009;360(22):2277–88.PubMedCrossRefGoogle Scholar
  44. 44.
    Haidry RJ, Dunn JM, Butt MA, et al. Radiofrequency ablation and endoscopic mucosal resection for dysplastic barrett’s esophagus and early esophageal adenocarcinoma: outcomes of the UK National Halo RFA registry. Gastroenterology. 2013;145(1):87–95.PubMedCrossRefGoogle Scholar
  45. 45.
    Haidry RJ, Butt MA, Dunn J, et al. Radiofrequency ablation for early oesophageal squamous neoplasia: outcomes form United Kingdom registry. World J Gastroenterol. 2013;19(36):6011–9.PubMedPubMedCentralCrossRefGoogle Scholar
  46. 46.
    Richter JE. Esophageal dilation in eosinophilic esophagitis. Best Pract Res Clin Gastroenterol. 2015;29(5):815–28.PubMedCrossRefGoogle Scholar
  47. 47.
    Richter JE. Endoscopic treatment of eosinophilic esophagitis. Gastrointest Endosc Clin N Am. 2018;28(1):97–110.PubMedCrossRefGoogle Scholar
  48. 48.
    Moawad FJ, Molina-Infante J, Lucendo AJ, Cantrell SE, Tmanova L, Douglas KM. Systematic review with meta-analysis: endoscopic dilation is highly effective and safe in children and adults with eosinophilic oesophagitis. Aliment Pharmacol Ther. 2017;46(2):96–105.PubMedCrossRefGoogle Scholar
  49. 49.
    Dougherty M, Runge TM, Eluri S, Dellon ES. Esophageal dilation with either bougie or balloon technique as a treatment for eosinophilic esophagitis: a systematic review and meta-analysis. Gastrointest Endosc. 2017;86(4):581–91. e583.PubMedPubMedCentralCrossRefGoogle Scholar
  50. 50.
    Gentile N, Katzka D, Ravi K, et al. Oesophageal narrowing is common and frequently under-appreciated at endoscopy in patients with oesophageal eosinophilia. Aliment Pharmacol Ther. 2014;40(11–12):1333–40.PubMedCrossRefGoogle Scholar
  51. 51.
    Richter JE. Esophageal dilation for eosinophilic esophagitis: it’s safe! Why aren’t we doing more dilations? Gastrointest Endosc. 2017;86(4):592–4.PubMedCrossRefGoogle Scholar
  52. 52.
    Lee GS, Craig PI, Freiman JS, de Carle D, Cook IJ. Intermittent dysphagia for solids associated with a multiringed esophagus: clinical features and response to dilatation. Dysphagia. 2007;22(1):55–62.PubMedCrossRefGoogle Scholar
  53. 53.
    Madanick RD, Shaheen NJ, Dellon ES. A novel balloon pull-through technique for esophageal dilation in eosinophilic esophagitis (with video). Gastrointest Endosc. 2011;73(1):138–42.PubMedCrossRefGoogle Scholar
  54. 54.
    Fukagawa T, Gotoda T, Oda I, et al. Stenosis of esophago-jejuno anastomosis after gastric surgery. World J Surg. 2010;34(8):1859–63.PubMedCrossRefGoogle Scholar
  55. 55.
    Williams VA, Watson TJ, Zhovtis S, et al. Endoscopic and symptomatic assessment of anastomotic strictures following esophagectomy and cervical esophagogastrostomy. Surg Endosc. 2008;22(6):1470–6.CrossRefGoogle Scholar
  56. 56.
    Honkoop P, Siersema PD, Tilanus HW, Stassen LP, Hop WC, van Blankenstein M. Benign anastomotic strictures after transhiatal esophagectomy and cervical esophagogastrostomy: risk factors and management. J Thorac Cardiovasc Surg. 1996;111(6):1141–6; discussion 1147-1148.PubMedCrossRefGoogle Scholar
  57. 57.
    Pierie JP, de Graaf PW, Poen H, van der Tweel I, Obertop H. Incidence and management of benign anastomotic stricture after cervical oesophagogastrostomy. Br J Surg. 1993;80(4):471–4.PubMedCrossRefGoogle Scholar
  58. 58.
    Briel JW, Tamhankar AP, Hagen JA, et al. Prevalence and risk factors for ischemia, leak, and stricture of esophageal anastomosis: gastric pull-up versus colon interposition. J Am Coll Surg. 2004;198(4):536–41; discussion 541-532.PubMedCrossRefGoogle Scholar
  59. 59.
    Hui JM, Hunt DR, de Carle DJ, Williams R, Cook IJ. Esophageal pneumatic dilation for postfundoplication dysphagia: safety, efficacy, and predictors of outcome. Am J Gastroenterol. 2002;97(12):2986–91.PubMedCrossRefGoogle Scholar
  60. 60.
    Pessaux P, Arnaud JP, Delattre JF, Meyer C, Baulieux J, Mosnier H. Laparoscopic antireflux surgery: five-year results and beyond in 1340 patients. Arch Surg. 2005;140(10):946–51.PubMedCrossRefGoogle Scholar
  61. 61.
    Marjanovic G, Schrag HJ, Fischer E, Hopt UT, Fischer A. Endoscopic bougienage of benign anastomotic strictures in patients after esophageal resection: the effect of the extent of stricture on bougienage results. Dis Esophagus. 2008;21(6):551–7.PubMedCrossRefGoogle Scholar
  62. 62.
    Lee J, Song HY, Ko HK, et al. Fluoroscopically guided balloon dilation or temporary stent placement for patients with gastric conduit strictures after esophagectomy with esophagogastrostomy. AJR Am J Roentgenol. 2013;201(1):202–7.PubMedCrossRefGoogle Scholar
  63. 63.
    Sutcliffe RP, Forshaw MJ, Tandon R, et al. Anastomotic strictures and delayed gastric emptying after esophagectomy: incidence, risk factors and management. Dis Esophagus. 2008;21(8):712–7.PubMedCrossRefGoogle Scholar
  64. 64.
    Hirdes MM, van Hooft JE, Koornstra JJ, et al. Endoscopic corticosteroid injections do not reduce dysphagia after endoscopic dilation therapy in patients with benign esophagogastric anastomotic strictures. Clin Gastroenterol Hepatol. 2013;11(7):795–801. e791.PubMedCrossRefGoogle Scholar
  65. 65.
    Hanaoka N, Ishihara R, Motoori M, et al. Endoscopic balloon dilation followed by intralesional steroid injection for anastomotic strictures after esophagectomy: a randomized controlled trial. Am J Gastroenterol. 2018;113(10):1468–74.PubMedCrossRefGoogle Scholar
  66. 66.
    Atsumi K, Shioyama Y, Nakamura K, et al. Predictive factors of esophageal stenosis associated with tumor regression in radiation therapy for locally advanced esophageal cancer. J Radiat Res. 2010;51(1):9–14.PubMedCrossRefGoogle Scholar
  67. 67.
    Alevronta E, Ahlberg A, Mavroidis P, et al. Dose-response relations for stricture in the proximal oesophagus from head and neck radiotherapy. Radiother Oncol. 2010;97(1):54–9.PubMedCrossRefGoogle Scholar
  68. 68.
    Caudell JJ, Schaner PE, Desmond RA, Meredith RF, Spencer SA, Bonner JA. Dosimetric factors associated with long-term dysphagia after definitive radiotherapy for squamous cell carcinoma of the head and neck. Int J Radiat Oncol Biol Phys. 2010;76(2):403–9.PubMedCrossRefGoogle Scholar
  69. 69.
    Tuna Y, Kocak E, Dincer D, Koklu S. Factors affecting the success of endoscopic bougia dilatation of radiation-induced esophageal stricture. Dig Dis Sci. 2012;57(2):424–8.PubMedCrossRefGoogle Scholar
  70. 70.
    Caudell JJ, Schaner PE, Meredith RF, et al. Factors associated with long-term dysphagia after definitive radiotherapy for locally advanced head-and-neck cancer. Int J Radiat Oncol Biol Phys. 2009;73(2):410–5.PubMedCrossRefGoogle Scholar
  71. 71.
    Francis DO, Hall E, Dang JH, Vlacich GR, Netterville JL, Vaezi MF. Outcomes of serial dilation for high-grade radiation-related esophageal strictures in head and neck cancer patients. Laryngoscope. 2015;125(4):856–62.PubMedCrossRefGoogle Scholar
  72. 72.
    Boyce HW, Estores DS, Gaziano J, Padhya T, Runk J. Endoscopic lumen restoration for obstructive aphagia: outcomes of a 25-year experience. Gastrointest Endosc. 2012;76(1):25–31.PubMedCrossRefGoogle Scholar
  73. 73.
    Chapuy CI, Annino DJ, Tishler RB, Haddad RI, Snavely A, Goguen LA. Success of endoscopic pharyngoesophageal dilation after head and neck cancer treatment. Laryngoscope. 2013;123(12):3066–73.PubMedPubMedCentralCrossRefGoogle Scholar
  74. 74.
    Garcia A, Flores RM, Schattner M, et al. Endoscopic retrograde dilation of completely occlusive esophageal strictures. Ann Thorac Surg. 2006;82(4):1240–3.PubMedCrossRefGoogle Scholar
  75. 75.
    Dellon ES, Cullen NR, Madanick RD, et al. Outcomes of a combined antegrade and retrograde approach for dilatation of radiation-induced esophageal strictures (with video). Gastrointest Endosc. 2010;71(7):1122–9.PubMedCrossRefGoogle Scholar
  76. 76.
    Langerman A, Stenson KM, Ferguson MK. Retrograde endoscopic-assisted esophageal dilation. J Gastrointest Surg. 2010;14(7):1186–9.PubMedCrossRefGoogle Scholar
  77. 77.
    Moyer MT, Stack BC Jr, Mathew A. Successful recovery of esophageal patency in 2 patients with complete obstruction by using combined antegrade retrograde dilation procedure, needle knife, and EUS needle. Gastrointest Endosc. 2006;64(5):789–92.PubMedCrossRefGoogle Scholar
  78. 78.
    Gonzalez JM, Vanbiervliet G, Gasmi M, Grimaud JC, Barthet M. Efficacy of the endoscopic rendez-vous technique for the reconstruction of complete esophageal disruptions. Endoscopy. 2016;48(2):179–83.PubMedGoogle Scholar
  79. 79.
    Contini S, Scarpignato C. Caustic injury of the upper gastrointestinal tract: a comprehensive review. World J Gastroenterol. 2013;19(25):3918–30.PubMedPubMedCentralCrossRefGoogle Scholar
  80. 80.
    Mamede RC, de Mello Filho FV. Ingestion of caustic substances and its complications. Sao Paulo Med J. 2001;119(1):10–5.PubMedCrossRefGoogle Scholar
  81. 81.
    Ryu HH, Jeung KW, Lee BK, et al. Caustic injury: can CT grading system enable prediction of esophageal stricture? Clin Toxicol (Phila). 2010;48(2):137–42.CrossRefGoogle Scholar
  82. 82.
    Zargar SA, Kochhar R, Mehta S, Mehta SK. The role of fiberoptic endoscopy in the management of corrosive ingestion and modified endoscopic classification of burns. Gastrointest Endosc. 1991;37(2):165–9.PubMedCrossRefGoogle Scholar
  83. 83.
    Isbister GK, Page CB. Early endoscopy or CT in caustic injuries: a re-evaluation of clinical practice. Clin Toxicol (Phila). 2011;49(7):641–2.CrossRefGoogle Scholar
  84. 84.
    Lahoti D, Broor SL, Basu PP, Gupta A, Sharma R, Pant CS. Corrosive esophageal strictures: predictors of response to endoscopic dilation. Gastrointest Endosc. 1995;41(3):196–200.PubMedCrossRefGoogle Scholar
  85. 85.
    Mutaf O, Genc A, Herek O, Demircan M, Ozcan C, Arikan A. Gastroesophageal reflux: a determinant in the outcome of caustic esophageal burns. J Pediatr Surg. 1996;31(11):1494–5.PubMedCrossRefGoogle Scholar
  86. 86.
    Wang RW, Zhou JH, Jiang YG, et al. Prevention of stricture with intraluminal stenting through laparotomy after corrosive esophageal burns. Eur J Cardiothorac Surg. 2006;30(2):207–11.PubMedCrossRefGoogle Scholar
  87. 87.
    Pelclova D, Navratil T. Do corticosteroids prevent oesophageal stricture after corrosive ingestion? Toxicol Rev. 2005;24(2):125–9.PubMedCrossRefGoogle Scholar
  88. 88.
    Berger M, Ure B, Lacher M. Mitomycin C in the therapy of recurrent esophageal strictures: hype or hope? Eur J Pediatr Surg. 2012;22(2):109–16.PubMedCrossRefGoogle Scholar
  89. 89.
    Gercek A, Ay B, Dogan V, Kiyan G, Dagli T, Gogus Y. Esophageal balloon dilation in children: prospective analysis of hemodynamic changes and complications during general anesthesia. J Clin Anesth. 2007;19(4):286–9.PubMedCrossRefGoogle Scholar
  90. 90.
    Doo EY, Shin JH, Kim JH, Song HY. Oesophageal strictures caused by the ingestion of corrosive agents: effectiveness of balloon dilatation in children. Clin Radiol. 2009;64(3):265–71.PubMedCrossRefGoogle Scholar
  91. 91.
    Ilkin Naharci M, Tuzun A, Erdil A, et al. Effectiveness of bougie dilation for the management of corrosive esophageal strictures. Acta Gastroenterol Belg. 2006;69(4):372–6.PubMedGoogle Scholar
  92. 92.
    Singhal S, Kar P. Management of acid- and alkali-induced esophageal strictures in 79 adults by endoscopic dilation: 8-years’ experience in New Delhi. Dysphagia. 2007;22(2):130–4.PubMedCrossRefGoogle Scholar
  93. 93.
    Kim JH, Song HY, Kim HC, et al. Corrosive esophageal strictures: long-term effectiveness of balloon dilation in 117 patients. J Vasc Interv Radiol. 2008;19(5):736–41.PubMedCrossRefGoogle Scholar
  94. 94.
    Gumaste VV, Dave PB. Ingestion of corrosive substances by adults. Am J Gastroenterol. 1992;87(1):1–5.PubMedGoogle Scholar
  95. 95.
    Contini S, Scarpignato C, Rossi A, Strada G. Features and management of esophageal corrosive lesions in children in Sierra Leone: lessons learned from 175 consecutive patients. J Pediatr Surg. 2011;46(9):1739–45.PubMedCrossRefGoogle Scholar
  96. 96.
    Panieri E, Rode H, Millar AJ, Cywes S. Oesophageal replacement in the management of corrosive strictures: when is surgery indicated? Pediatr Surg Int. 1998;13(5–6):336–40.PubMedCrossRefGoogle Scholar
  97. 97.
    Graham J, Barnes N, Rubenstein AS. The nasogastric tube as a cause of esophagitis and stricture. Am J Surg. 1959;98(1):116–9.PubMedCrossRefGoogle Scholar
  98. 98.
    Zaninotto G, Bonavina L, Pianalto S, Fassina A, Ancona E. Esophageal strictures following nasogastric intubation. Int Surg. 1986;71(2):100–3.PubMedGoogle Scholar
  99. 99.
    Yoon YS, Kim JY, Lee KJ, Yu KP, Lee MS. Balloon dilatation for an esophageal stricture by long-term use of a nasogastric tube: a case report. Ann Rehabil Med. 2014;38(4):581–4.PubMedPubMedCentralCrossRefGoogle Scholar
  100. 100.
    Siersema PD, de Wijkerslooth LR. Dilation of refractory benign esophageal strictures. Gastrointest Endosc. 2009;70(5):1000–12.PubMedCrossRefGoogle Scholar
  101. 101.
    Ashcraft KW, Holder TM. The expeimental treatment of esophageal strictures by intralesional steroid injections. J Thorac Cardiovasc Surg. 1969;58(5):685–91. passim.PubMedGoogle Scholar
  102. 102.
    Ramage JI Jr, Rumalla A, Baron TH, et al. A prospective, randomized, double-blind, placebo-controlled trial of endoscopic steroid injection therapy for recalcitrant esophageal peptic strictures. Am J Gastroenterol. 2005;100(11):2419–25.PubMedCrossRefGoogle Scholar
  103. 103.
    Camargo MA, Lopes LR, Grangeia Tde A, Andreollo NA, Brandalise NA. Use of corticosteroids after esophageal dilations on patients with corrosive stenosis: prospective, randomized and double-blind study. Rev Assoc Med Bras (1992). 2003;49(3):286–92.CrossRefGoogle Scholar
  104. 104.
    Burdick JS, Venu RP, Hogan WJ. Cutting the defiant lower esophageal ring. Gastrointest Endosc. 1993;39(5):616–9.PubMedCrossRefGoogle Scholar
  105. 105.
    Hordijk ML, Siersema PD, Tilanus HW, Kuipers EJ. Electrocautery therapy for refractory anastomotic strictures of the esophagus. Gastrointest Endosc. 2006;63(1):157–63.PubMedCrossRefGoogle Scholar
  106. 106.
    Hordijk ML, van Hooft JE, Hansen BE, Fockens P, Kuipers EJ. A randomized comparison of electrocautery incision with Savary bougienage for relief of anastomotic gastroesophageal strictures. Gastrointest Endosc. 2009;70(5):849–55.PubMedCrossRefGoogle Scholar
  107. 107.
    Pungpapong S, Raimondo M, Wallace MB, Woodward TA. Problematic esophageal stricture: an emerging indication for self-expandable silicone stents. Gastrointest Endosc. 2004;60(5):842–5.PubMedCrossRefGoogle Scholar
  108. 108.
    Wadhwa RP, Kozarek RA, France RE, et al. Use of self-expandable metallic stents in benign GI diseases. Gastrointest Endosc. 2003;58(2):207–12.PubMedCrossRefGoogle Scholar
  109. 109.
    Repici A, Vleggaar FP, Hassan C, et al. Efficacy and safety of biodegradable stents for refractory benign esophageal strictures: the BEST (biodegradable esophageal stent) study. Gastrointest Endosc. 2010;72(5):927–34.PubMedCrossRefGoogle Scholar
  110. 110.
    Fuccio L, Hassan C, Frazzoni L, Miglio R, Repici A. Clinical outcomes following stent placement in refractory benign esophageal stricture: a systematic review and meta-analysis. Endoscopy. 2016;48(2):141–8.PubMedGoogle Scholar
  111. 111.
    Kim JH, Song HY, Choi EK, Kim KR, Shin JH, Lim JO. Temporary metallic stent placement in the treatment of refractory benign esophageal strictures: results and factors associated with outcome in 55 patients. Eur Radiol. 2009;19(2):384–90.PubMedCrossRefGoogle Scholar
  112. 112.
    Canena JM, Liberato MJ, Rio-Tinto RA, et al. A comparison of the temporary placement of 3 different self-expanding stents for the treatment of refractory benign esophageal strictures: a prospective multicentre study. BMC Gastroenterol. 2012;12:70.PubMedPubMedCentralCrossRefGoogle Scholar
  113. 113.
    Hirdes MM, Vleggaar FP, Siersema PD. Stent placement for esophageal strictures: an update. Expert Rev Med Devices. 2011;8(6):733–55.PubMedCrossRefGoogle Scholar
  114. 114.
    Hirdes MM, Siersema PD, van Boeckel PG, Vleggaar FP. Single and sequential biodegradable stent placement for refractory benign esophageal strictures: a prospective follow-up study. Endoscopy. 2012;44(7):649–54.PubMedCrossRefGoogle Scholar
  115. 115.
    Repici A, Small AJ, Mendelson A, et al. Natural history and management of refractory benign esophageal strictures. Gastrointest Endosc. 2016;84(2):222–8.PubMedCrossRefGoogle Scholar
  116. 116.
    Wong KK, Hendel D. Self-dilation for refractory oesophageal strictures: an Auckland City Hospital study. N Z Med J. 2010;123(1321):49–53.PubMedGoogle Scholar
  117. 117.
    Qin Y, Sunjaya DB, Myburgh S, et al. Outcomes of oesophageal self-dilation for patients with refractory benign oesophageal strictures. Aliment Pharmacol Ther. 2018;48(1):87–94.PubMedCrossRefGoogle Scholar
  118. 118.
    Zehetner J, DeMeester SR, Ayazi S, Demeester TR. Home self-dilatation for esophageal strictures. Dis Esophagus. 2014;27(1):1–4.PubMedCrossRefGoogle Scholar
  119. 119.
    van Halsema EE, t Hoen CA, de Koning PS, Rosmolen WD, van Hooft JE, Bergman JJ. Self-dilation for therapy-resistant benign esophageal strictures: towards a systematic approach. Surg Endosc. 2018;32(7):3200–7.PubMedPubMedCentralCrossRefGoogle Scholar
  120. 120.
    Zhang Y, Wang X, Liu L, Chen JP, Fan ZN. Intramuscular injection of mitomycin C combined with endoscopic dilation for benign esophageal strictures. J Dig Dis. 2015;16(7):370–6.PubMedCrossRefGoogle Scholar
  121. 121.
    Mendez-Nieto CM, Zarate-Mondragon F, Ramirez-Mayans J, Flores-Flores M. Topical mitomycin C versus intralesional triamcinolone in the management of esophageal stricture due to caustic ingestion. Rev Gastroenterol Mex. 2015;80(4):248–54.PubMedGoogle Scholar
  122. 122.
    Javed A, Pal S, Dash NR, Sahni P, Chattopadhyay TK. Outcome following surgical management of corrosive strictures of the esophagus. Ann Surg. 2011;254(1):62–6.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.University of South Florida Division of Digestive Diseases and NutritionTampaUSA
  2. 2.Division of Digestive Diseases and NutritionJoy Mccann Culverhouse Center for Swallowing Disorders, Joy Culverhouse Center for Swallowing Disorders, Division of Digestive Diseases and NutritionTampaUSA

Personalised recommendations