Effective diameter of balloon dilation for benign esophagojejunal anastomotic stricture after total gastrectomy.
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.
Kim
Chan Gyoo
CG
Research Institute and Hospital, National Cancer Center, Goyang, Korea.
Choi
Il Ju
IJ
Lee
Jong Yeul
JY
Cho
Soo-Jeong
SJ
Lee
Jun Ho
JH
Ryu
Keun Won
KW
Park
Sook Ryun
SR
Bae
Jae-Moon
JM
Kim
Young-Woo
YW
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