RISK FACTORS FOR REFRACTORY BENIGN ESOPHAGEAL STRICTURES

Aims Endoscopic dilatation remains the mainstay of therapeutic management of benign esophageal strictures. They can be caused by various disorders or lesions of the esophagus.

Our aim is to report the results of dilatation, as well as the different risk factors of refractory benign esophageal strictures.

Methods This is a retrospective descriptive and analytical study of 33 patients with benign esophageal stenosis who underwent esophageal dilation between 2016 and 2021. Refractory (or recurrent) stenosis was defined as the inability to maintain esophageal caliber at 14 mm diameter over 5 dilatation sessions, or the inability to maintain satisfactory luminal diameter for 4 weeks once a 14 mm diameter was achieved.

Results Of the 33 patients who underwent dilatation for benign esophageal strictures, 38.7% had refractory strictures. The mean age was 50±20.9 years with a sex ratio (M/F) of 2.

All patients had dysphagia and 45.5% had chronic gastroesophageal reflux disease (GERD). Endoscopy revealed low stenosis in 65.6%, medium in 15.6% and high in 18.8%. 50% had peptic stenosis, 31.3% achalasia, 9.4% anastomotic, 6.3% Schatzki ring and 3.1% caustic.

78.8% of the stenoses were dilated by balloon and 21.2% by candles with a mean dilatation caliber of 18.8±6.8 mm.

After univariate analysis, refractory stenoses were associated with the presence of a peptic stenosis (p=0.002) and dilatations of caliber less than 16mm (p=0.012), after multivariate analysis only peptic stenosis was associated with refractory stenoses (p=0.034).

Conclusions In our series, refractory stenosis was present in 38.7%. Peptic stenosis was statistically significantly associated with refractory oesophageal stenosis.

Publication History

Article published online:
14 April 2022