title: Endoscopic balloon dilatation for pharyngo-upper esophageal stricture after treatment of head and neck cancer.
abstract: OBJECTIVE
  Dysphagia caused by pharyngo-upper esophageal stricture is a complication of treatment for head and neck cancer. Endoscopic balloon dilation (EBD) is in widespread use as an effective and safe treatment for stricture in many areas of the gastrointestinal tract. In the present study, we investigated the efficacy and safety of EBD for pharyngo-upper esophageal strictures that developed after treatment for head and neck cancer.
  
  
  METHODS
  From January 2010 to December 2013, the medical records and endoscopic findings of 19 consecutive patients with pharyngo-upper esophageal strictures occurring after surgery and/or chemoradiotherapy for head and neck cancer were retrospectively examined.
  
  
  RESULTS
  Mean number of EBD sessions per patient was 6.6 (1-30), and mean maximum diameter of dilation was 15.8 (11-20) mm. Technical success was achieved in 16 of 19 (84.2%) patients, and only two major complications (bleeding and pha ryngeal edema) occurred in a total of 125 dilatation sessions (1.6%). Regarding the influence of chemoradiotherapy on the outcome of EBD, patients who had undergone chemoradiotherapy plus surgery experienced significantly more restenosis during the follow-up period compared to those who had undergone surgery alone (50% vs 0%, P < 0.05).
  
  
  CONCLUSIONS
  This retrospective analysis demonstrated the efficacy and safety of exclusive EBD for pharyngo-upper esophageal strictures occurring after treatment for head and neck cancer, indicating that the therapeutic application of EBD could be extended to such strictures. Patients who underwent chemoradiotherapy and surgery experienced more restenosis; hence, such patients should be carefully followed up after EBD treatment.
authors.affiliation: Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Ryuhei
authors.initials: R
authors.lastname: Maejima
authors.forename: Katsunori
authors.initials: K
authors.lastname: Iijima
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Koike
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Ara
authors.forename: Kaname
authors.initials: K
authors.lastname: Uno
authors.forename: Waku
authors.initials: W
authors.lastname: Hatta
authors.forename: Takenori
authors.initials: T
authors.lastname: Ogawa
authors.forename: Ken-ichi
authors.initials: K
authors.lastname: Watanabe
authors.forename: Yukio
authors.initials: Y
authors.lastname: Katori
authors.forename: Tooru
authors.initials: T
authors.lastname: Shimosegawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015331:Cohort Studies; D016208:Databases, Factual; D003680:Deglutition Disorders / Q000209:etiology / Q000628:therapy; D004106:Dilatation / Q000295:instrumentation* / Q000379:methods; D004940:Esophageal Stenosis / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D004945:Esophagoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000628:therapy; D012189:Retrospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D015996:Survival Rate; D016896:Treatment Outcome
keywords: dysphagia; endoscopic balloon dilation (EBD); head and neck cancer; pharyngo-upper esophageal stricture; restenosis