A new simple endoscopic incision therapy for refractory benign oesophageal anastomotic stricture

2021 ◽  
Vol 14 (3) ◽  
pp. e239798
Author(s):  
Jeongmin Choi ◽  
Soo In Choi

Oesophageal anastomotic stricture is a frequent complication after esophagectomy. In most cases, endoscopic bougination or balloon dilation usually resolves anastomotic stricture. However, some refractory oesophageal strictures remain difficult to treat and cause significant morbidity. Recently, successful treatment using endoscopic incisional therapy has been reported in several cases. We report a case of refractory benign oesophageal anastomotic stricture after oesophagectomy. A 72-year-old man underwent three consecutive bouginations. However, he developed progressive stricture. Stricture was successfully treated with an endoscopic knife incision. We performed only three incisions without a cutting method, which was new compared with previous reports. A new simple endoscopic incision technique is effective and safe for stricture management. In conclusion, endoscopic incisional therapy may be recommended as a salvage treatment for properly selected patients with refractory benign stricture who do not respond to conventional therapy.

2007 ◽  
Vol 74 (4) ◽  
pp. 212-216
Author(s):  
A. Frattini ◽  
E. Capocasale ◽  
P Granelli ◽  
M.P. Mazzoni ◽  
U. Maestroni ◽  
...  

Introduction and Objectives Ureteral stenosis and vesicocoureteral reflux after renal transplantation represent a key concern because of their incidence and the associated morbidity. Prompt diagnosis and minimally invasive treatment are mandatory in immunosuppressed patients with single kidney. The aim of this study is to evaluate the success rate of the endourological techniques in the management of such complications. Materials and Methods Between January 1996 and December 2006, 647 kidney transplants were performed. Urinary tract continuity was re-established by ureteroneocystostomy according to Gregoir-Lich technique. We observed 13 cases of ureteral stenosis (2%) and 11 cases of symptomatic vesicoureteric reflux (1.7%). The endourogical procedure was performed in 13 patients: 5 cases of II-III grade vesicoureteric reflux, 4 early ureteral stenosis and 4 late ureteral stenosis. Patients with vesicoureteric reflux underwent endoscopic injection of macroplastique in 4 cases and Durasphere in 1. Early ureteral stenoses were treated using balloon dilation in 2 cases, balloon dilation and laser endoureterotomy in 3, ureteral stent placement in the other. Recipients with late stenosis underwent laser incision and balloon dilation in 2 cases, balloon dilation in 1 and a laser incision only in the last case. Combined antegrade and retrograde endoscopic approach was performed in 7 patients, whereas retrograde access in 1. Results Endourologic treatment was successful in 9 cases (69.2%); 2 patients required open reconstructive surgery due to endourological technique failure (early ureteropelvic junction stricture, late ureterovesical anastomotic stricture). Vesicoureteric reflux was corrected in 3 patients (60%), 2 patients underwent uretero-ureterostomy for recurrent reflux. No technique-related morbidity was observed. With a mean follow-up of 81.6 months, 8 patients show normal renal function, 5 patients have returned to haemodialysis (4 for chronic rejection, 1 for carcinoma in the graft). Conclusions Considering their low morbidity and the satisfactory success rate, we claim that endourological procedures should be considered the preferred treatment for ureteral stenosis and vesicoureteric reflux in selected patients.


2016 ◽  
Vol 55 (15) ◽  
pp. 2093-2099 ◽  
Author(s):  
Nobuyuki Ashizawa ◽  
Shigeki Nakamura ◽  
Shotaro Ide ◽  
Masato Tashiro ◽  
Takahiro Takazono ◽  
...  

Endoscopy ◽  
2011 ◽  
Vol 43 (S 02) ◽  
pp. E187-E188 ◽  
Author(s):  
S. Park ◽  
H. Chun ◽  
B. Keum ◽  
B. Lee ◽  
Y. Seo ◽  
...  

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