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 esophagus were treated with electrocautery and were followed for 12 months. All patients had recurrence of dysphagia despite repeated bougienage.


METHODS
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 treatments 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.
Hordijk
Marjan L
ML
Department of Gastroenterology and Hepatology, Erasmus MC University Medical Centre Rotterdam, The Netherlands.
Siersema
Peter D
PD
Tilanus
Hugo W
HW
Kuipers
Ernst J
EJ
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D004106:Dilatation; D004564:Electrocoagulation; D004940:Esophageal Stenosis / Q000209:etiology / Q000601:surgery*; D004945:Esophagoscopy; D004947:Esophagus / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012008:Recurrence; D013270:Stomach / Q000601:surgery; D016896:Treatment Outcome