title: Effective diameter of balloon dilation for benign esophagojejunal anastomotic stricture after total gastrectomy.
abstract: BACKGROUND
  Benign strictures at esophagojejunostomy sites may develop after total gastrectomy, and through-the-scope balloon dilation (TTS-BD) can relieve them. The aim of this study was to evaluate effective and safe balloon diameter for benign stricture after total gastrectomy.
  
  
  METHODS
  From June 2001 to December 2006, 930 gastric cancer patients underwent total gastrectomy with Roux-en-Y esophagojejunostomy in a cancer center hospital. We performed TTS-BD when benign strictures developed. Initial success rate, complication rate, and restenosis rate were evaluated. We classified the patients into three groups according to final dilation diameter and number of sessions.
  
  
  RESULTS
  A total of 58 patients (6.2%) developed a benign stricture at the esophagojejunostomy site. We classified them into three groups based on the final luminal diameter of the balloon used and the number of sessions, as follows: group A (n = 20), 13.5-15 mm in one or two sessions; group B (n = 13), 16.5-20 mm in one session; group C (n = 25), 16.5-20 mm in two sessions. The initial success rates were 100% for groups A and B and 96% for group C. A perforation occurred in one patient (7.7%) in group B. Restenosis occurred in two patients (10%) in group A, one patient (7.7%) in group B, and in no patients in group C (p = 0.29). Restenosis was resolved by one or two further TTS-BDs.
  
  
  CONCLUSIONS
  TTS-BD to 15 mm was a safe and effective treatment for benign esophagojejunostomy strictures following total gastrectomy. Restenosis was not common and could be resolved by one or two further TTS-BD sessions.
authors.affiliation: Research Institute and Hospital, National Cancer Center, Goyang, Korea.
authors.forename: Chan Gyoo
authors.initials: CG
authors.lastname: Kim
authors.forename: Il Ju
authors.initials: IJ
authors.lastname: Choi
authors.forename: Jong Yeul
authors.initials: JY
authors.lastname: Lee
authors.forename: Soo-Jeong
authors.initials: SJ
authors.lastname: Cho
authors.forename: Jun Ho
authors.initials: JH
authors.lastname: Lee
authors.forename: Keun Won
authors.initials: KW
authors.lastname: Ryu
authors.forename: Sook Ryun
authors.initials: SR
authors.lastname: Park
authors.forename: Jae-Moon
authors.initials: JM
authors.lastname: Bae
authors.forename: Young-Woo
authors.initials: YW
authors.lastname: Kim
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery; D000328:Adult; D000368:Aged; D000713:Anastomosis, Roux-en-Y; D002404:Catheterization / Q000295:instrumentation* / Q000379:methods; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D004867:Equipment Design; D004940:Esophageal Stenosis / Q000209:etiology / Q000628:therapy*; D004947:Esophagus / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D007579:Jejunal Diseases / Q000209:etiology / Q000628:therapy*; D007583:Jejunum / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000628:therapy*; D012008:Recurrence; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000601:surgery*; D055815:Young Adult