Initial experience with a dual-anchor stent for anastomotic strictures after oesophagectomy

Abstract

OBJECTIVES: Benign gastro-oesophageal anastomotic strictures after oesophagectomy can occur in up to 42% of patients. Traditional management includes serial dilations. We report our initial experience with the use of a dual-anchor, lumen-apposing endoluminal stent for the management of recurrent anastomotic strictures after oesophagectomy. METHODS: Retrospective review of patients who underwent 'off label' placement of a dual-anchor stent for recurrent anastomotic strictures. We report indications and short-term outcomes. RESULTS: We placed four self-expanding dual-anchor stents for recurrent anastomotic strictures from January to July 2015. The most common symptom was dysphagia. The anastomosis was cervical in two patients, intrathoracic oesophagojejunal anastomosis in one and intrathoracic oesophagogastric anastomosis in another patient. Initial treatment was with repeated dilations with Savary-Gilliard rigid dilators. Two complications occurred from the prestent dilations. One stent had to be removed; the three other patients are doing well without dysphagia and were able to resume a regular diet. CONCLUSIONS: The use of self-expanding dual-anchor stents appears to be safe and adds value to the treatment of benign anastomotic strictures after oesophagectomy.