Combined approach dilatation of complete oesophageal stenoses
DOI:
https://doi.org/10.18203/issn.2454-5929.ijohns20202199Keywords:
Oesophageal dilatation, Oesophageal stenosis, Squamous cell carcinoma, Dysphagia, RadiotherapyAbstract
Background: Upper oesophageal stenosis is a well-recognised complication in the treatment of head and neck malignancies that can result in significant morbidity. Simple strictures can be managed by anterograde dilatation. Combined approach dilatation can overcome more complex and even complete stenosis.
Methods: This was a retrospective analysis of prospectively gathered data for four patients who have had combined approach dilatation to overcome complete oesophageal stenosis. Outcomes determined using standardised swallowing outcome measurement tools.
Results: A functional oesophageal lumen was restored in four patients with complete oesophageal stenosis, with a demonstrable improvement in validated swallowing outcome measures.
Conclusions: Combined approach oesophageal dilatation can be safely and effectively utilised to overcome complete stenosis of the upper oesophagus secondary to radiotherapy/chemo-radiotherapy. Extending the indications for this procedure to post-surgical strictures is not advisable due to increased risk of serious complication.
Metrics
References
Mcquone SJ, Eisele DW. Management of pharyngeal and esophageal stenosis. Oper Tech Otolaryngol - Head Neck Surg. 1997;8(4):231-41.
Twisk VJJ, Brummer RJ, Manni JJ. Retrograde approach to pharyngo-esophageal obstruction. Gastrointest Endosc. 1998;48(3):296-9.
Lew RJ, Shah JN, Chalian A, Weber RS, Williams NN, Kochman ML. Technique of endoscopic retrograde puncture and dilatation of total esophageal stenosis in patients with radiation-induced strictures. Head Neck. 2004;26(2):179-83.
Langerman A, Stenson KM, Ferguson MK. Retrograde endoscopic-assisted esophageal dilation. J Gastrointest Surg. 2010;14(7):1186-9.
Goguen LA, Norris CM, Jaklitsch MT, Sullivan CA, Posner MR, Haddad RI, et al. Combined antegrade and retrograde esophageal dilation for head and neck cancer-related complete esophageal stenosis. Laryngoscope. 2010;120(2):261-6.
Kos MP, David EF, Mahieu HF. Anterograde-retrograde rendezvous approach for radiation-induced complete upper oesophageal sphincter stenosis: case report and literature review. J Laryngol Otol. 2011;125(7):761-4.
Miah MS, Zealley IA, Alijani A, Mcguire B, Mountain RE, Mahendran S, et al. A Simple Combined Antegrade Radiological and Retrograde Endoscopic Procedure to Recanalise Fibrotic Hypopharyngo-Oesophageal Occlusions: Technical Description and Lessons from Clinical Outcome in Three Cases. Int J Otolaryngol Head Neck Surg. 2013;2(5):179-85.
Francis DO, Hall E, Dang JH, Vlacich GR, Netterville JL, Vaezi MF. Outcomes of serial dilation for high-grade radiation-related esophageal strictures in head and neck cancer patients. Laryngoscope. 2015;125(4):856-62.
List M, Sterr RC, Lansky SB. A performance status scale for head and neck cancer patients. Cancer. 1990: 564-569.
Crary MA, Mann CGD, Groher ME. Initial psychometric assessment of a functional oral intake scale for dysphagia in stroke patients. Arch Phys Med Rehabil. 2005;86(8):1516-20.
Fowlkes J, Zald PB, Andersen P. Management of complete esophageal stricture after treatment of head and neck cancer using combined anterograde retrograde esophageal dilation. Head Neck. 2012;34(6):821-5.
Gavriel H, Duong C, Spillane J, Sizeland A. Bidirectional esophageal dilatation in pharyngoesophageal stenosis postradiotherapy. Head Neck. 2013;35(5):733-7.