title: Management of complete esophageal stricture after treatment of head and neck cancer using combined anterograde retrograde esophageal dilation.
abstract: BACKGROUND
  Complete esophageal stricture is a difficult problem to manage. There is limited literature to support clinical decision-making. To evaluate outcomes and efficacy, we performed a retrospective medical chart review of patients who received combined anterograde retrograde esophageal dilation (CARD) between 2002 and 2009 at our institution.
  
  
  METHODS
  Fifteen patients were identified who developed a stricture requiring CARD after treatment for head and neck cancers. Outcomes were pretreatment and posttreatment diet, gastrostomy tube status, and operative complications.
  
  
  RESULTS
  Six of 15 patients were gastrostomy tube-free at last follow-up and 11 of 15 patients were taking oral nutrition. There were 4 complications. One patient died. Two gastrostomy tube site complications occurred. One patient sustained a dental injury.
  
  
  CONCLUSIONS
  CARD offers benefit to most patients. Despite risks associated with the procedure, CARD should be considered by the clinician and patient in management of complete esophageal stricture.
authors: Department of Otolaryngology, Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon, USA.
authors: Jonathan
authors: J
authors: Fowlkes
authors: Philip B
authors: PB
authors: Zald
authors: Peter
authors: P
authors: Andersen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000150:complications / Q000628:therapy; D059248:Chemoradiotherapy / Q000009:adverse effects; D003680:Deglutition Disorders / Q000209:etiology / Q000628:therapy*; D004106:Dilatation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D004750:Enteral Nutrition; D004940:Esophageal Stenosis / Q000209:etiology / Q000628:therapy*; D004945:Esophagoscopy; D005260:Female; D005774:Gastrostomy; D006258:Head and Neck Neoplasms / Q000150:complications / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012509:Sarcoma / Q000150:complications / Q000628:therapy; D055815:Young Adult