Safety and efficacy of large balloon dilatation under fluoroscopy. Issue 1 (17th September 2021)

• Record Type: Journal Article
• Authors: Wang, Shuai; Yin, Meipan; Wang, Meng; Tong, Yalin; Zhao, Yue; Ma, Yaozhen; Li, Xiaobing; Xie, Pengfei; Wu, Gang
• Other Names: Zaidi Mone guestEditor.
• Is Part Of: Annals of the New York Academy of Sciences. Volume 1503:Issue 1(2021)
• Page Start: 102
• Page End: 109
• Publication Date: 2021-09-17
• Subjects: esophageal cancer -- esophagogastric anastomotic stricture -- balloon dilatation -- interventional radiology; Medical sciences -- Periodicals; Medicine -- Periodicals; Science -- Periodicals; 610
• DOI: 10.1111/nyas.14682
• Languages: English
• ISSNs: 0077-8923

Abstract

Abstract: The maximum diameter of the balloon used for balloon dilatation(BD) of esophagogastric anastomotic stricture (EAS) is generally 20 millimeters. This study aimed to evaluate the safety and efficacy of BD under fluoroscopy, using balloons with a diameter of 25–30 millimeters. We retrospectively analyzed the data of patients with benign EAS treated by large BD (balloon diameter, 25–30 mm) under fluoroscopy. The Cox proportional hazards model (PHM) was used to identify the factors associated with stricture‐free survival. The results show that a total of 127 patients were included in this study, and 204 BDs were performed. The technical success rate was 96.6%, and the clinical success rate was 99.2%. The incidence of serious adverse events was 3.4% (7/204). One patient died of massive hemorrhage during BD, and nine patients were lost to follow‐up. For the remaining 117 patients, the median stricture‐free survival period was 14.9 months. In multivariable analysis using the Cox PHM, only balloon diameter was significantly associated with stricture‐free survival. The stricture‐free survival period tended to increase as balloon diameter increased. Large BD under fluoroscopy appears to be safe and effective for the treatment of benign EAS after esophagectomy. Abstract : We conclude that large fluoroscopic balloon dilatation is a safe and effective option for the treatment of benign esophagogastric anastomotic leakage (EAS). It has high technical and clinical success rates, low recurrence rate and major adverse events, and the stricture‐free survival period is long. It may become the first treatment for benign EAS. However, in patients with a history of radiotherapy, a large balloon should be used with caution as there is a risk of bleeding or perforation.