Fluoroscopic guidance biopsy for severe anastomotic stricture after esophagogastrostomy of esophageal carcinoma

Abstract

To determine the safety and effectiveness of fluoroscopic guidance biopsy in the diagnosis of serve anastomotic stricture after esophagogastrostomy for esophageal carcinoma.A total of 55 patients with severe anastomotic stricture were enrolled for forceps biopsy between June 2013 and July 2017. Chest computed tomography (CT) and esophagogram were used to determine the location and extent of stricture. Specimens were collected from the site of stricture by using biopsy forceps under fluoroscopic guidance. Stooler's dysphagia score was compared before and after treatment.The technical success rate of fluoroscopic guidance biopsy was 100%, with no serious complications occurred. A total of 38 patients were diagnosed as benign stricture, of which, 2 patients were further diagnosed as cancer by further biopsy, with a missed diagnosis rate of 5.3%, and 1 patient developed squamous cell carcinoma after 5 months. Thus 20 cases were diagnosed as cancer, 3 cases were adenocarcinoma and 17 cases were squamous cell carcinoma. Balloon dilation was performed for 20 patients (33 times) of benign stricture, and 9 patients (10 times) of malignant stricture. A total of 26 esophageal covered stents were implanted for benign restenosis after repeated balloon dilation. A total of 8 esophageal covered stents were implanted for malignant stricture. After esophagus stenting, dysphagia was immediately alleviated. The dysphagia score decreased from 3.4 ± 0.1 to 0.7 ± 0.1 (P < .001) after treatment.Fluoroscopic guidance biopsy is a safe and effective procedure for directing appropriate treatment of anastomotic stricture after esophagogastrostomy, and it may be an alternative approach for patients who cannot tolerate fibergastroscopy.

<p>LOC441178 Overexpression Inhibits the Proliferation and Migration of Esophageal Carcinoma Cells via Methylation of miR-182</p>

“…7 However, the serious side effects and unexpected risks are not uncommon, including esophageal perforation, hemorrhage, dysphagia. 8,9 Therefore, exploring the promising therapeutic molecular targets may help to understand the diagnosis and treatment of EC.…”

Long-term outcomes of large balloon dilatation for benign anastomotic stricture following surgical resection of esophageal cancer

“…The treatment strategies and prognosis of postoperative anastomosis are different between malignant and benign stricture. [16] Accurate diagnosis and early treatment can prolong life expectation and improve patient's quality of life. [16,17] Benign anastomotic stricture usually occur 3 months after resection, the treatment is very difficult and prone to recurrence of stricture.…”

“…[16] Accurate diagnosis and early treatment can prolong life expectation and improve patient's quality of life. [16,17] Benign anastomotic stricture usually occur 3 months after resection, the treatment is very difficult and prone to recurrence of stricture. [18] Management of benign anastomotic strictures often require serial balloon dilatation, with significant cost, potential risk, and inconvenience.…”

“…The treatment strategies and prognosis of postoperative anastomosis are different between malignant and benign stricture. [ 16 ] Accurate diagnosis and early treatment can prolong life expectation and improve patient’s quality of life. [ 16 , 17 ]…”

Clinical observation of different anti-reflux methods in the treatment of gastroesophageal reflux disease with hiatus hernia

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