Electrocautery therapy for refractory anastomotic strictures of the esophagus

Background Anastomotic esophageal stenoses after esophageal resection are common and sometimes are refractory to Savary bougie dilation. The efficacy of electrocautery needle-knife treatment in these patients is described. Methods Twenty patients with a refractory anastomotic stricture of the esopha...

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Bibliographic Details
Published inGastrointestinal endoscopy Vol. 63; no. 1; pp. 157 - 163
Main Authors Hordijk, Marjan L., MD, Siersema, Peter D., MD, Tilanus, Hugo W., MD, Kuipers, Ernst J., MD
Format Journal Article
LanguageEnglish
Published New York, NY Mosby, Inc 01.01.2006
Elsevier
Subjects
Adult
Aged
Anastomosis, Surgical
Biological and medical sciences
Digestive system. Abdomen
Dilatation
Electrocoagulation
Endoscopy
Esophageal Stenosis - etiology
Esophageal Stenosis - surgery
Esophagoscopy
Esophagus - surgery
Female
Gastroenterology and Hepatology
Gastroenterology. Liver. Pancreas. Abdomen
Humans
Investigative techniques, diagnostic techniques (general aspects)
Male
Medical sciences
Middle Aged
Postoperative Complications
Recurrence
Stomach - surgery
Treatment Outcome
Refractory
Stenosis
Treatment
Esophagus
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Summary:Background Anastomotic esophageal stenoses after esophageal resection are common and sometimes are refractory to Savary bougie dilation. The efficacy of electrocautery needle-knife treatment in these patients is described. Methods Twenty patients with a refractory anastomotic stricture of the esophagus were treated with electrocautery and were followed for 12 months. All patients had recurrence of dysphagia despite repeated bougienage. Observations All 12 patients with a stricture shorter than 1 cm remained without dysphagia after a single treatment. In all 8 patients with a long-segment stenosis of 1.5 to 5 cm, dysphagia recurred, and a mean of 3 treatments were necessary. The interval between electrocautery was significantly longer compared with bougienage. There were no complications. The body weight of all patients increased. Conclusions Electrocautery seems to be a good single-treatment modality for refractory short-segment anastomotic strictures, whereas longer-segment stenoses appear to require repeated treatment sessions before similar results are obtained.
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ISSN:0016-5107
1097-6779
DOI:10.1016/j.gie.2005.06.016