Performance of Endoscopic Dilation in Patients with Esophageal Stenosis due to Radiotherapy for Aerodigestive Tract Malignancy: Retrospective Cohort

This retrospective study aimed to evaluate the outcome of dysphagia after endoscopic dilation (ED) in patients with esophageal stricture (ES) after radiotherapy (RDT) for malignancies of the aerodigestive tract (MAT) and the secondary objectives: rates of adverse events and risk factors.We included patients aged > 18 years who underwent ED in ES after RDT for MAT within a one-year period.A total of 191 endoscopic esophageal dilations (EED) were performed in 63 patients.Twenty individuals were included in the study, 14 (70%) men, with a mean age of 67.2 years.All underwent treatment with RDT 16 (80%) underwent surgery and 14 (70%) chemotherapy.They complained of dysphagia and before starting treatment, 7 (35%) were able to swallow some solid foods, 6 (30%) swallowed semi-solids and 7 (35%) reported complete dysphagia for liquids.In the endoscopic aspect prior to the first dilation, 6 (30%) had simple stenosis and 14 (70%) complex, the latter being significantly related to the factors of refractoriness (p 0.05) and recurrence (p 0.04).The instrument used in the first session of 12 (60%) patients was a Savary-Gilliard dilators, 5 (25%) started with a hydrostatic balloon and 3 (15%) with the passage of the endoscope.After the procedure, only 1 (5%) patient had suspected perforation, which was ruled out after computed tomography.During the study period, 4 (20%) participants were lost to follow-up, 3 (15%) died, 6 (30%) had resolution of dysphagia complaints and 7 (35%) continued to perform ED.We conclude that EED in patients with MAT after RDT treatment is common and multifactorial.EED remains the treatment of choice in these cases; however, it is observed that this is a distinct group of patients, in which there is a higher rate of refractoriness and recurrence when compared with EED for other benign causes of stenosis.However, there are few case series describing the effect of dilation procedures in this group of patients.