Intermittent endoscopic dilation - A new method to prevent restenosis after benign esophageal stricture incision

Abstract

A 38-year-old man was hospitalized on April 2, 2022, due to esophageal ulcer and stricture. No tumor cells were found in the pathological biopsy. Considering the diagnosis of benign esophageal stricture, he underwent an endoscopic esophageal stricture incision on April 6. By April 12, he was free from dysphagia, showed no signs of stricture via endoscopy, and was discharged from the hospital. However, after three weeks, the patient experienced dysphagia again, and gastroscopy revealed esophageal restenosis. On May 6, 2022, a second endoscopic esophageal stricture incision was performed, followed by ongoing endoscopic dilation to prevent further restenosis during the subsequent three-month follow-up. The patient did not report any further swallowing obstruction. During the eight-month follow-up post-operation, no esophageal stricture was observed, the ulcer had completely healed, and the patient's weight increased by 10 kg. Endoscopic incision for benign esophageal stricture is effective, yet some patients are susceptible to restenosis. Intermittent endoscopic dilation, as compared to balloon dilation and bougie dilation, may offer a cost-effective and efficient approach to prevent recurrence of esophageal stricture or post-ESD stricture in early esophageal cancer, particularly in primary medical units.