Treatment of esophageal stricture after surgery

This is an automatically translated article.

The article is expertly consulted by MSc Duong Xuan Loc - Gastroenterologist - General Surgery Department - Vinmec Danang International General Hospital. The doctor has more than 12 years of experience as a Gastroenterologist.
Surgery in general or esophageal surgery in particular carries the risk of postoperative complications. One of them is the narrowing of the esophageal junction, making it difficult for the patient to eat and drink. Esophageal stricture after surgery can cause dangerous complications if not treated promptly.

1. Narrowing of the esophageal anastomosis after surgery

The esophagus is a tube connecting the pharynx to the stomach that carries food into the stomach. The esophagus is about 25cm long and 1.5cm in diameter. Anatomically, the esophagus is divided into three segments: neck, thorax, and abdomen, and has three strictures. Structurally, the esophagus consists of layers of skeletal muscle, smooth muscle, submucosa and mucosa
Post-operative esophageal stricture is a common complication after esophageal surgery. Esophageal stricture makes it difficult to swallow food, sometimes food gets stuck in the narrow, causing choking, difficulty breathing.

2. Treatment of esophageal stricture after surgery

2.1 Esophageal dilatation

Dilation is a mechanical method to treat esophageal stricture.
Esophageal dilation with plastic tubes: Tubes of various sizes and 1cm metal wire marked with contrast on the screen. Esophageal dilation follows the principle that when there is moderate resistance, less than three consecutive tubes, less than 1mm in diameter, should be used in one dilation session.
Balloon esophagectomy includes balloons of all sizes and leads. This method follows the principle that the ball diameter should not exceed the narrow spot diameter by more than 2mm and be less than or equal to three times the narrow spot diameter. One session should not exceed three times and must inject 1-2ml of silicone oil before inserting the balloon.
Esophageal dilation is a simple procedure, this method helps prevent narrowing of the esophageal anastomosis, but it must be performed many times if you want to bring the best effect.

2.2 Esophageal stenting

This is the method applied to the case that has been treated with balloon esophagectomy. After the esophagus is dilated, a stent is placed in the narrowed segment and fixed there. This method helps prop against the wall of the esophagus and keeps the esophagus from narrowing and allowing food to pass more easily.

2.3 Esophageal surgery

If the two methods of esophageal dilation and esophageal stent are not effective, the specialist will recommend esophageal surgery. This is a fast-acting treatment. However, after surgical treatment, esophageal stricture is still at risk of recurrence after a few years.

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