Gut Liver.  2014 Jul;8(4):394-399.

Endoscopy-Guided Balloon Dilation of Benign Anastomotic Strictures after Radical Gastrectomy for Gastric Cancer

• Lee HJ
• Park W
• Lee H
• Lee KH
• Park JC
• Shin SK
• Lee SK
• Lee YC
• Noh SH

Abstract

BACKGROUND/AIMS
The aim of this study was to evaluate the outcome of endoscopic dilation for benign anastomotic stricture after radical gastrectomy in gastric cancer patients.
METHODS
Gastric cancer patients who underwent endoscopic balloon dilation for benign anastomosis stricture after radical gastrectomy during a 6-year period were reviewed retrospectively.
RESULTS
Twenty-one patients developed benign strictures at the site of anastomosis. The majority of strictures occurred within 1 year after surgery (95.2%). The median duration to stenosis after surgery was 1.70 months (range, 0.17 to 23.97 months). The success rate of the first endoscopic dilation was 61.9%. Between the restenosis group (n=8) and the no restenosis group (n=13), there were no significant differences in the body mass index (22.82 kg/m2 vs 22.46 kg/m2), interval to symptom onset (73.9 days vs 109.3 days), interval to treatment (84.6 days vs 115.6 days), maximal balloon diameter (14.12 mm vs 15.62 mm), number of balloon dilation sessions (1.75 vs 1.31), location of gastric cancer or type of surgery. One patient required surgery because of stricture refractory to repeated dilation.
CONCLUSIONS
Endoscopic dilation is a highly effective treatment for benign anastomotic strictures after radical gastrectomy for gastric cancer and should be considered a primary intervention prior to proceeding with surgical revision.

Keyword

Stomach neoplasms; Anastomotic stricture; Radical gastrectomy; Endoscopic dilation

MeSH Terms

Anastomosis, Surgical/adverse effects
Constriction, Pathologic/etiology/therapy
Dilatation/*methods
Female
Gastrectomy/*adverse effects
Gastroscopy/*methods
Humans
Male
Middle Aged
Recurrence
Retrospective Studies
Stomach Neoplasms/*surgery
Treatment Outcome