title: Electroincision of refractory esophagogastric anastomotic strictures.
abstract: Most esophagogastric anastomotic strictures can be successfully managed with endoscopic dilation. However, strictures that do not respond to repeated dilation (refractory strictures) are difficult to manage. We report a series of nine patients treated with needle-knife electroincision of symptomatic esophagogastric anastomotic strictures refractory to balloon or Savary dilation. Prior to needle-knife electroincision, the median symptom-free interval between dilations was 13 days; median number of dilations was six (range 3-12). After electroincision, 8/9 patients have experienced a reduction in dysphagia symptoms and a reduced need for endoscopic dilations (follow-up: 90-420 days). No complications occurred. Needle-knife stricturoplasty of refractory esophagogastric anastomotic strictures may produce improved clinical results and may delay or eliminate dysphagia recurrence.
authors.affiliation: Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
authors.forename: D T
authors.initials: DT
authors.lastname: Simmons
authors.forename: T H
authors.initials: TH
authors.lastname: Baron
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects*; D002404:Catheterization; D003251:Constriction, Pathologic / Q000628:therapy; D004598:Electrosurgery / Q000379:methods*; D004935:Esophageal Diseases / Q000628:therapy*; D004943:Esophagogastric Junction / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged