Abstract:

Objective To investigate the clinical effect of gradient step⁃by⁃step balloon dilatation guided by digital subtraction angiography（DSA）for anastomotic stricture after esophageal cancer surgery. Methods The clinical data of 69 patients with anastomotic stricture after esophageal cancer surgery who underwent DSA guided gradient step⁃by⁃step balloon dilatation from February 2015 to May 2020 in our hospital were retrospectively analyzed. According to the size of anastomotic stoma before and after dilatation，dysphagia grade and quality of life score were assessed. Results DSA guided gradient step⁃by⁃step balloon dilatation effectively improved dysphagia symptoms in patients with anastomotic stricture after esophageal cancer surgery. No statistical significance was found in surgical methods and anastomotic dilatation effect（P > 0.05）；the dilatation effect of balloon dilatation and esophageal cancer surgery within 12 weeks was better than that within 12 weeks（P < 0.05）；the effect of the first two balloon dilatation time within 2 weeks was better than that at more than 2 weeks（P < 0.05）；the quality of life score of patients with more than two dilations was higher than that of patients with only two dilations（P < 0.05）. Conclusion For anastomotic stricture after esophageal cancer surgery，DSA guided gradient step⁃by⁃step balloon dilatation had obvious advantages. Progressive dilatation could be performed by gradient pressure method during operation. The most appropriate dilatation endpoint could be selected. Balloon dilatation within 12 weeks after operation and the second balloon dilatation within 2 weeks after interval improved the dilatation effect of anastomotic stoma. Appropriate increase of dilatation times could improve the quality of life score of patients.

Key words:

DSA, balloon dilatation, esophageal cancer, postoperative anastomotic stenosis ,