Radial incision and cutting method for refractory stricture after nonsurgical treatment of esophageal cancer

• Published in: Endoscopy Vol. 45; no. 4; p. 316
• Main Authors: Yano, T, Yoda, Y, Satake, H, Kojima, T, Yagishita, A, Oono, Y, Ikematsu, H, Kaneko, K
• Format: Journal Article
• Language: English
• Published: Germany 2013
• Subjects: Aged; Chemoradiotherapy - adverse effects; Deglutition Disorders - etiology; Deglutition Disorders - surgery; Dilatation; Esophageal Neoplasms - therapy; Esophageal Stenosis - complications; Esophageal Stenosis - etiology; Esophageal Stenosis - surgery; Humans; Male; Middle Aged; Photochemotherapy - adverse effects
• ISSN: 1438-8812
• DOI: 10.1055/s-0032-1326016

Strictures remaining after nonsurgical treatment for esophageal cancer are generally more refractory to endoscopic balloon dilation (EBD) when compared with anastomotic strictures. The aim of the present study was to evaluate the efficacy and safety of a radial incision and cutting (RIC) method for the treatment of refractory strictures after nonsurgical treatment of esophageal cancer. All subjects complained of grade 2 or worse dysphagia, even after at least 10 sessions of EBD. Between August 2009 and May 2012, eight consecutive patients with refractory esophageal stricture after nonsurgical treatments, including chemoradiotherapy (CRT) alone (n = 3), CRT followed by salvage endoscopic treatment (n = 3), or endoscopic submucosal dissection (ESD; n = 2), underwent the RIC procedure. After the RIC procedure, dysphagia in all the patients dramatically improved to grade 1 or 0 without any major complications; however, the long-term efficacy was unfavorable as only 37.5 % (3 /8) demonstrated adequate lumen patency at 3 months, and re-intervention was necessary in six patients (75 %).