Endoscopic Dilatation in the Management of Benign Esophageal Strictures: Predictive Factors for Recurrence

Aims In the era of proton pump inhibitors, endoscopic dilatation remains the cornerstone of therapeutic management for benign esophageal strictures. These can be caused by various disorders or lesions of the esophagus and clinically manifest as dysphagia, which can significantly impact quality of life. However, the rate of symptomatic recurrence one year after dilatation remains non-negligible. We conducted a cross-sectional study with the primary aim of identifying predictive factors for recurrence of benign esophageal strictures following endoscopic dilatation.

Methods This is a retrospective, descriptive, and analytical cross-sectional study involving patients with benign esophageal strictures who underwent esophageal dilatation between January 2020 and February 2024. Demographic data, characteristics of the stricture, details of the procedure, and the number of recurrences were collected. Early recurrence was defined as the reappearance of symptoms (dysphagia, gastroesophageal reflux disease) within one year of endoscopic dilatation. Predictive factors for recurrence were identified using logistic regression with the Jamovi software

Results Forty-six patients were included in our study, with a mean age of 50.4±19.8 years and a marked male predominance (sex ratio M/F=2.1). Esophageal strictures were of peptic origin in 37.8% of cases, caustic in 40%, anastomotic or secondary to achalasia in 8.9%, and due to a Schatzki ring in 4.4%. Among these, 63% were tight, 66% involved the lower esophagus, 17.8% the middle portion, and 15.6% the upper portion. Balloon dilatation was performed in 80.4% of cases, while bougie dilatation was used in 19.6%, with a median dilatation diameter of 16.5 mm [15–30], and an immediate success rate of 93.5%. The early recurrence rate was 42%. The factors independently associated with recurrence of the stricture, identified through multivariate analysis, were peptic origin of the stricture (OR=6; p=0.02) and the number of dilatations (OR=2.2; p=0.05)

Conclusions In our series, the early recurrence rate was 42%. Peptic strictures were the main factor associated with recurrence.

Publikationsverlauf

Artikel online veröffentlicht:
27. März 2025