Original articleClinical endoscopyUsefulness of endoscopic radial incision and cutting method for refractory esophagogastric anastomotic stricture (with video)
Section snippets
Patients
From May 2006 to March 2011, 32 consecutive patients with refractory anastomotic stricture after esophagogastric surgery were treated with RIC and were followed up at the National Cancer Center Hospital East and the Kyoto University Hospital. Refractory esophagogastric stricture was considered when the stricture could not be improved to a diameter larger than 10 mm and 3 or more sessions of EBD (CRE balloon dilator, Boston Scientific, Natick, MA) with at least 1 week of interval had been
Patient characteristics
Patient characteristics are summarized in Table 1. In the RIC group, the median age was 66 years (range, 33-81 years), and the male-to-female ratio was 26:6. The strictures were caused by esophagectomy in 30 patients (93.8%), and the remaining 2 strictures (6.2%) were caused by proximal gastrectomy. The median number of EBD sessions per patient before RIC was 10 (range, 3-56 sessions) and the median latency of strictures requiring EBD before RIC was 5.8 months (range, 1.3-172 months). Before
Discussion
Most esophagogastric anastomotic strictures can be managed successfully with EBD or rigid dilation. However, refractory strictures that do not respond to repeated dilation are difficult to manage. In addition, refractory anastomotic strictures impair severely the patients' quality of life and adequate food intake.
This study shows that the application of the RIC method by using an IT knife for the treatment of refractory anastomotic strictures was effective and safe. The demonstration of the
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DISCLOSURE: All authors disclosed no financial relationships relevant to this publication.
See CME section; p. 1068.