Evaluation and management of benign esophageal strictures

Ferguson, Dawn D.

doi:10.1111/j.1442-2050.2005.00516.x

Cited by 111 publications

(87 citation statements)

References 41 publications

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“…Dilation has been proven to be both safe and effective as a first-line therapy for esophageal stricture, whereas surgical resection is indicated in cases of established refractory stricture (1). However, extensive injury and postoperative restenosis often ensue.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Incision with Esophageal Stenting Helped to Remove a Gastrostomy Tube in a Patient with Refractory Stricture

et al. 2015

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Most cases of esophageal benign stricture can be successfully managed with dilation; however, refractory stricture is often unresponsive to repeated dilation. Endoscopic incision is a novel technique for treating refractory esophageal stricture, although recurrence is noted in patients with stricture measuring greater than 1.5 cm, thus requiring the use of repeated incisions and/or preventive dilation. We herein report a case of refractory esophageal stricture treated with an endoscopic incision and esophageal stenting, which successfully allowed the gastrostomy tube to be removed.

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Section: Introductionmentioning

confidence: 99%

Endoscopic Incision with Esophageal Stenting Helped to Remove a Gastrostomy Tube in a Patient with Refractory Stricture

et al. 2015

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“…The esophageal stricture is quite refractory [1][2][3][4] . Because our present results showed that the failure load of the scar tissue was significantly decreased, a risk of perforation by the dilatation therapy should be considered.…”

Section: Macroscopic Appearance and Histological Findingsmentioning

confidence: 99%

“…Benign esophageal stricture often follows severe inflammation of the esophageal wall, which is caused by chronic reflux of gastric acid, radiation injury, or accidental ingestion of alkali 1,2) . Furthermore, according to recent advances in endoscopic therapy for early stage esophageal carcinoma or high-grade dysplasia, the incidence of esophageal stricture has been increasing as a complication after mucosal resection for widespread lesions 3,4) .…”

Section: Introductionmentioning

confidence: 99%

The mechanism of esophageal stricture after endoscopic resection: Histological and biomechanical evaluation in a canine model

Honda

Kobayashi

Nakayama

et al. 2017

Ann. Cancer Res. Therap.

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Background and study aims: Benign esophageal stricture has major deleterious effects on a patient's quality of life and is often refractory. This study aims were to prepare the animal model and to investigate the mechanism of esophageal stricture in the view point of histological and biomechanical evaluation. Material and method: Nine beagle dogs were enrolled in this study. Under general anesthesia, circumferential endoscopic submucosal dissection was carried out 5 cm length in thoracic esophagus for preparing stricture models. The process of stricture formation was evaluated by the endoscopic observation and histological findings. Immunohistochemical staining was performed for collagen I or collagen III. In the biomechanical evaluation, rectangular-shaped specimens were obtained from the esophageal samples. The failure load and linear stiffness were measured using a tensile tester and compared healed tissue with normal. Results: The dogs developed severe stricture. The macroscopic appearance showed a deep ulcer formation and severe mucosal constriction. No esophageal glands or muscularis mucosae were evident, and instead, they were replaced with condensed granulation tissue that were composed type I and III collagen fibers. The inner circular muscular layer of the muscularis propria showed partial atrophy and fibrosis in the center of the lesion. The failure load and linear stiffness were significantly decreased in the healed tissue. Conclusion:The cause of benign esophageal stricture might have been the biomechanical deterioration that was caused the change of the collagen components in the submucosal layers or atrophic changes of inner circular muscles.

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“…For refractory strictures, temporary emplacement of self-expanding stents is also used. Surgery should be considered in patients with inadequate response to dilation and medical therapy [16] .…”

Section: Classification and Therapeutic Optionsmentioning

confidence: 99%

Peptic Esophageal Stricture: Medical Treatment

Pregun

Hritz

Tulassay

et al. 2009

Dig Dis

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Peptic esophageal stricture as a consequence of gastroesophageal reflux disease is the most frequent among benign esophageal strictures. The incidence is low and has been decreasing since the 1990s with a parallel increase in proton pump inhibitor use. Dysphagia is a common symptom: accurate diagnostic procedures (barium esophagogram, upper endoscopy with biopsies) have to be performed to exclude malignant causes first. Medical (acid-suppressive) therapy, endoscopic dilation and surgical intervention are the main therapeutic options. Based on the results of randomized and observational studies evaluating the effect of acid-suppressive therapy on peptic stricture outcome, healing the coexistent esophagitis seems to be essential. Effective acid-suppressive therapy with proton pump inhibitors may reduce the need for repeated dilations and provide symptom relief and better clinical outcome. In refractory strictures, local steroid injection is likely beneficial.

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Evaluation and management of benign esophageal strictures

Cited by 111 publications

References 41 publications

Endoscopic Incision with Esophageal Stenting Helped to Remove a Gastrostomy Tube in a Patient with Refractory Stricture

Endoscopic Incision with Esophageal Stenting Helped to Remove a Gastrostomy Tube in a Patient with Refractory Stricture

The mechanism of esophageal stricture after endoscopic resection: Histological and biomechanical evaluation in a canine model

Peptic Esophageal Stricture: Medical Treatment

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