Objective: To investigate the manifestations,etiology,diagnosis and treatment of benign gastric strictures after transthoracic esophagectomy and esophagogastrostomy.
Methods: From January 1998 to December 2004, 9 cases with benign gastric strictures following esophagectomy were enrolled in the study. The manifestations,radiographic and endoscopic findings, treatment were analyzed retrospectively.
Results: The patients included 8 males and 1 female. Benign gastric stricture is characterized by mucosa absence and proliferation of fibrous tissue in the stomach below the stoma. The age ranged from 49 to 71 years old (median age 62). The common symptom was postoperative dysphagia. The length of stricture ranged from 1.5 to 5.0 cm, and the width from 0.1 to 0.5 cm. Seven cases were treated ineffectively with simple dilation,while esophageal stent placement was performed in 8 cases successfully. After follow- up from 5 to 60 months, restenosis occurred for 11 times including stent fall-off for 6 times,stent migration for 1 times, overgrowth of granular tissues for 4 times. Other complications included cervical incision infection and massive hemorrhage in one case respectively. Restenoses were all solved with stent replacement.
Conclusions: Benign gastric stricture should be diagnosed through dysphagia, barium meal and endoscopy. Placement of non-self-expandable stent or whole covered self-expandable metallic stent is the primary treatment.