Treatment of unusual esophageal stenosis caused by gastroesophageal reflux disease

Li, Zhi Tong; Ji, Feng; Han, Xiaodan; Li, Teng Fei; Wang, Zhong Gao

doi:10.5152/tjg.2016.16469

Cited by 1 publication

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References 4 publications

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“…In a prospective study, the authors reported no prophylactic effect of omeprazole (2 mg/kg) on post-esophageal atresia stricture, and no effect on reducing the number of endoscopic dilations [ 31 ]. For medication-refractory GERD patients, fundoplication may represent an important treatment option [ 7 , 32 ]. LARS not only improved reflux, but also controlled reflux-related symptoms [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic antireflux surgery or PPIs in the management of reflux-related esophageal stricture

Kong

Zhang

et al. 2022

Surg Endosc

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Background Gastroesophageal reflux disease (GERD) is often associated with esophageal stricture, particularly benign esophageal stricture. We aimed to evaluate the effects of balloon catheter dilation (BD) combined with laparoscopic fundoplication (LF) surgery and proton pump inhibitors (PPIs) in patients with reflux-induced esophageal strictures. Methods We retrospectively analyzed 116 patients with reflux-induced benign esophageal strictures who underwent balloon dilatation therapy combined with PPIs (BD-PPIs group, n = 58) and balloon dilatation combined with LF (BD-LF group, n = 58). Patients were followed up for 24 months. The outcomes of the patients were monitored, including clinical success, symptom improvement, adverse events, and the frequency of esophagitis. Results At the latest follow-up, the rate of clinical success was higher in BD-LF group than in BD-PPIs group (80.4% vs. 57.7%, P = 0.011). The patients in the BD-PPIs group required more dilation sessions to achieve successful dilation, as compared to those in the BD-LF group (2.1 ± 1.2 vs. 0.7 ± 0.8, P < 0.001). The DeMeester score, number of reflux episodes for which pH was < 4, and lower esophageal sphincter pressure were significantly better in the BD-LF group than in the BD-PPIs group (all P < 0.001). The incidence of reflux esophagitis was higher in the BD-PPIs group than in the BD-LF group, at 24 months (58.8% vs. 18.2%, P = 0.003). Conclusions Balloon dilatation with concomitant LF is effective and safe for esophageal stricture secondary to GERD. Moreover, antireflux surgery techniques, such as Nissen or Toupet procedure, should be added for reflux-induced benign esophageal stricture.

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