Retrograde balloon pull-through technique for benign esophageal strictures: a single-center pilot experience

TL;DR

A new balloon dilation technique for treating benign esophageal strictures shows high success and safety rates in a pilot study.

Contribution

The retrograde balloon pull-through technique is evaluated as a safe and effective alternative for benign esophageal stricture dilation.

Findings

Retrograde balloon dilation achieved 95.7% technical success in treating benign esophageal strictures.

The retrograde technique showed a nonsignificant trend toward lower repeat dilation rates compared to antegrade methods.

Only one minor adverse event occurred in the retrograde balloon group, indicating a high safety profile.

Abstract

Antegrade savary dilation and static balloon dilation are the mainstays of management of simple and complex benign esophageal strictures (BESs). A modified technique, termed retrograde balloon dilation, has potential advantages for the management of BESs. Efficacy and safety data on this technique are limited. We report a single-center experience of retrograde balloon dilation for BESs.

We conducted a retrospective study evaluating retrograde balloon and antegrade savary dilation for BESs in 53 unique patients who met inclusion criteria, including 23 undergoing a retrograde balloon pull-through technique and 30 undergoing antegrade savary dilation. The primary endpoint was technical success, defined as achieving a luminal diameter of ≥16 mm. Secondary endpoints were repeat dilation rates within 1 year after achieving therapeutic endpoint dilation and adverse events.

Technical success was achieved in 22 of 23 patients (95.7%) with the retrograde balloon pull-through technique and in all 30 patients (100%) with antegrade savary dilation (P = .434). A nonsignificant trend of lower repeat dilation rates was present for the retrograde balloon pull-through group, with 4 of 22 in the retrograde balloon pull-through group versus 12 of 30 in the antegrade savary dilation group (P = .076). Only 1 minor adverse event occurred in the retrograde balloon pull-through group.

Our experience suggests that retrograde balloon pull-through dilation is effective and safe for simple and complex benign esophageal stenosis.

Figures