The Long-Term Outcome Of Endoscopic Radio Incision With Balloon Dilation Or With Esophageal Stent Placement In Long-Segment Benign Esophageal Strictures

Background Endoscopic radio incision (ERI) is a novel treatment for benign esophageal strictures, especially for refractory stenoses. ERI provides a rapid improvement patency and exciting result in the short term. However, re-incision and/or dilation are required in some patients with long-segment strictures, and the long-term outcome of ERI is still controversial. The aim of this study was to evaluate the long-term efficacy of ERI with balloon dilation (BD) and ERI with esophageal stent placement (ESP) in long-segment benign esophageal strictures. Methods This study was a randomized prospective trial. 37 patients with 1.5–5 cm length benign esophageal strictures from July 2015 to December 2018 were enrolled (the median age was 67 years old, range 49–74; male: female 25:12) and followed up for 12 months. All patients were randomly assigned to two groups: the ERI with balloon dilation group (ERI+BD, n=18) and ERI with esophageal stent placement group (ERI+ESP, n=19). The clinical data were recorded, such as the diameter of stenoses, length of strictures, dysphagia scores before and after the procedure, complications. Results No severe adverse events were observed in either group. All patients in both groups were able to eat solid food within 1 week after the treatment. There was no significant difference between the ERI+BD group and the ERI+ESP group in dysphagia scores (1.3±0.5 vs 1.1±0.4, P \u003e 0.05) within 4 weeks after the procedure. In a 1-year follow-up, the relief rate of dysphagia symptom in the ERI+ESP group was higher than the ERI+BD group (84.2% vs 44.4%, P = 0.029). Comparing to the ERI+BD group, the majority of patients in the ERI+ESP group could maintain lumen patency at 12 months (78.9% vs 38.9%, P = 0.032). Conclusions Endoscopic radio incision (ERI) with esophageal stent placement (ESP) is the effective treatment for long-segment benign esophageal stricture, and provides a favorable result in the long-term.