Indication and Limitation of Endoscopic Dilation for Esophageal Anastomotic Stricture

Tokuyuki Yokohata, Toshio Takeshima, Yukihisa Miyazawa, Kota Okinaga, Shou Kuroki, Yasuhiko Morioka

Second Department of Surgery, Teikyo University School of Medicine
First Department of Surgery, Faculty of Medicine University of Tokyo¹⁾

Esophageal dilation using a plastic bougie and a balloon dilator was performed in 91 patients with postoperative anastomotic stricutre from October 1982 to February 1991. Indications for and limitations of the dilation procedure were re-evaluated retrospectively. Dilation was successful in 80 of the 84 patients with benign strictures. The number of dilations was 3.7 on average. More frequent dilations were necessary for the patients with anastomotic leakage after esophageal resection. The only unsuccessful dilation for benign strictures was in a patient with an esophago-cutaneous fistula. In the three patients with a long narrow segment, dilation was difficult. Dilation was unsuccessful in two of seven patients with malignant strictures with cancer recurrence, and was difficult in four patients. One patient died soon after dilation because of cancer recurrence. Complications of the dilation procedure occurred in six patients, including two with bleeding which required blood transfusion, two with fever, one with cervical subcutaneous abscess, and one with perforation. Only one patient was operated on for complications, and no patient died because of the complication. The dilation method using a plastic bougie and a balloon dilator is a simple, safe, and useful treatment for benign esophageal anastomotic stricture.

Key words
esophageal anastomotic stricture, balloon dilator, plastic bougie

Reprint requests
Tokuyuki Yokohata Second Department of Surgery, Teikyo University School of Medicine
2-11-1 Kaga, Itabashi-ku, Tokyo, 173 JAPAN

Accepted
July 3, 1991

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