title: Evaluation of combined argon plasma coagulation and Savary Bougienage for the relief of anastomotic-stenosis after esophageal squamous cancer surgery.
abstract: BACKGROUND
  Several endoscopic dilation techniques have been reported for treatment of anastomotic-stenosis of esophageal cancer, but the high incidence of dysphagia has remained unchanged. The aim of this study was to compare the effect of Argon Plasma Coagulation (APC) combined with Savary Bougienage (SB) compared to APC alone or SB alone for anastomotic-stenosis after radical operation for squamous cell carcinoma of the esophagus.
  
  
  METHODS
  Patients with anastomotic-stenosis that was diagnosed for the first time following esophageal squamous cell carcinoma resection surgery were randomly assigned to undergo APC combined with SB, APC alone, or SB alone. Primary endpoints were the dysphagia-free survival (DFS defined as the time from first dilatation of effectively relieved dysphagia to dysphagia relapse expressed in days) after 6 months of follow up.
  
  
  RESULTS
  A total of 90 patients from the Cancer Institute, First Affiliated Hospital of Henan University of Science and Technology were entered into the study (APC group, n = 30, SB group, n = 30, combination group [APC combined with SB], n = 30). Primary endpoints: 6 months after treatment, DFS of combination group (115.63 days; 95% CI, 105.31-125.95) was significantly longer than the APC alone group (39.53 days; 95% CI, 35.95-43.11, p = 0.000) and the SB alone group (16.93 days; 95% CI, 15.01-18.84, p = 0.000). No severe complications occurred within the three treatment groups.
  
  
  CONCLUSIONS
  APC combined with SB was a safe and well-tolerated method for relieving dysphagia of esophageal squamous cell cancer patients with anastomotic-stenosis. (Registered with randomized controlled trials, ChiCRT, registration number ChiCTR-TRC-13003757.)
authors.affiliation: Cancer Institute, First Affiliated Hospital of Henan University of Science and Technology, Luoyang, China.
authors.forename: Ruinuo
authors.initials: R
authors.lastname: Jia
authors.forename: Ruifeng
authors.initials: R
authors.lastname: Guo
authors.forename: Gang
authors.initials: G
authors.lastname: Liu
authors.forename: Xiang
authors.initials: X
authors.lastname: Yuan
authors.forename: Caihong
authors.initials: C
authors.lastname: Dong
authors.forename: Tanyou
authors.initials: T
authors.lastname: Shan
authors.forename: Xiaozhi
authors.initials: X
authors.lastname: Yuan
authors.forename: Yi
authors.initials: Y
authors.lastname: Zhang
authors.forename: Edmund Wing To
authors.initials: EW
authors.lastname: Tai
authors.forename: Xiaoshan
authors.initials: X
authors.lastname: Feng
authors.forename: Shegan
authors.initials: S
authors.lastname: Gao
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000009:adverse effects; D057908:Argon Plasma Coagulation; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D003131:Combined Modality Therapy; D003680:Deglutition Disorders / Q000209:etiology; D004106:Dilatation; D018572:Disease-Free Survival; D004938:Esophageal Neoplasms / Q000601:surgery*; D004940:Esophageal Stenosis / Q000209:etiology / Q000628:therapy*; D016629:Esophagectomy / Q000009:adverse effects; D004947:Esophagus / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013270:Stomach / Q000601:surgery*