title: Fluoroscopically guided balloon dilation or temporary stent placement for patients with gastric conduit strictures after esophagectomy with esophagogastrostomy.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the clinical features of patients with gastric conduit strictures after esophagectomy and to report our initial experience in the management of these strictures with fluoroscopically guided balloon dilation, temporary stent placement, or both.
  
  
  METHODS
  From January 1996 to January 2012, 12 patients with gastric conduit stricture after esophagectomy underwent fluoroscopic balloon dilation, temporary stent placement, or both. Stent placement was indicated in patients who had gastro-respiratory fistulas or recurrent symptoms within 2 weeks of balloon dilation. Technical and clinical success, complications, and length of strictures were retrospectively evaluated.
  
  
  RESULTS
  The mean length of strictures in all patients was 49 mm (range, 21-76 mm). The strictures were accompanied by gastrorespiratory fistulas in four patients. Seven patients with gastric conduit strictures without fistulas underwent 23 balloon dilations. Five patients underwent stent placement owing to gastrorespiratory fistula formation (n = 4) and frequent recurrent symptoms after balloon dilation (n = 1). During a mean follow-up period of 8 months (range, 2-28 months), clinical success was achieved in 11 patients (91.6%) after a single balloon dilation (n = 1), multiple balloon dilations (n = 5), or stent placement (n = 5). Complications occurred in 3 of 10 patients (30%) after balloon dilation and in one of five patients (20%) after stent placement.
  
  
  CONCLUSIONS
  Gastric conduit strictures are characterized by their substantial length and tend to be accompanied by gastrorespiratory fistulas. Despite relatively high complication and recurrence rates, this study may offer a viable treatment of gastric conduit strictures by using fluoroscopically guided balloon dilation and stent placement.
authors.affiliation: Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap 2-dong, Songpa-gu, Seoul, 138-736, Republic of Korea.
authors.forename: Jongjin
authors.initials: J
authors.lastname: Lee
authors.forename: Ho-Young
authors.initials: HY
authors.lastname: Song
authors.forename: Heung Kyu
authors.initials: HK
authors.lastname: Ko
authors.forename: Jung-Hoon
authors.initials: JH
authors.lastname: Park
authors.forename: Han Kyu
authors.initials: HK
authors.lastname: Na
authors.forename: Yong Hee
authors.initials: YH
authors.lastname: Kim
authors.forename: Hwoon-Yong
authors.initials: HY
authors.lastname: Jung
mesh_terms: D000368:Aged; D004106:Dilatation / Q000379:methods*; D004940:Esophageal Stenosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D016629:Esophagectomy; D005260:Female; D005471:Fluoroscopy; D005774:Gastrostomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000628:therapy*; D015641:Radiography, Interventional; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome