Fluoroscopically guided balloon dilation for patients with esophageal stricture after radiation treatment.
OBJECTIVE
To evaluate the safety and clinical effectiveness of fluoroscopically guided balloon dilation in patients with esophageal stricture after radiation therapy (RT).


METHODS
From April 1993 through December 2004, fluoroscopically guided balloon dilation was performed in 15 patients with esophageal strictures secondary to previous RT. Technical success, clinical success, recurrence of dysphagia, primary and secondary patency rates, and complications related to the procedure were retrospectively evaluated.


RESULTS
Twenty-five balloon dilations were performed in 15 patients, with a mean of 1.7 dilations per patient (range, 1-5). Technical success was achieved in all procedures. One patient was immediately lost to follow-up and another underwent elective esophageal surgery 13 days after the procedure. Of the remaining 13 patients, clinical success was achieved 11 (85%). Two of 13 patients exhibited recurrence of dysphagia before 1 month after balloon dilation. Among the 11 patients in whom clinical success was achieved, seven exhibited maintained initial improvement of dysphagia until their last follow-up (mean, 174 days) and four exhibited recurrence of dysphagia after the first balloon dilation. Dysphagia recurred 2-128 days (mean, 67.2 d) after the first balloon dilation in six of the 13 patients (46%), who underwent further balloon dilation and/or stent placement. The primary and secondary patency rates at 1, 3, and 6 months were 86%, 68%, and 47% and 100%, 92%, and 62%, respectively. There were no major complications. Type 1 and 2 esophageal ruptures occurred after 12 dilations in nine patients; they were treated conservatively.


CONCLUSIONS
Fluoroscopically guided balloon dilation for esophageal stricture after RT can be safe and effective. However, the high rate of recurrent dysphagia requires repeated dilations.
Choi
Gi Bok
GB
Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul, Korea.
Shin
Ji Hoon
JH
Song
Ho-Young
HY
Lee
Yong Seok
YS
Cho
Young-Kwon
YK
Bae
Jae-Ik
JI
Kim
Jong Hoon
JH
Jeong
Yang Hwa
YH
Park
Myeong Hwa
MH
D000328:Adult; D000368:Aged; D002404:Catheterization / Q000379:methods*; D003680:Deglutition Disorders / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D004940:Esophageal Stenosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000532:radiotherapy; D015641:Radiography, Interventional; D011878:Radiotherapy / Q000009:adverse effects*; D012008:Recurrence; D019233:Retreatment; D012189:Retrospective Studies; D016896:Treatment Outcome