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Management of complete esophageal stricture after treatment of head and neck cancer using combined anterograde retrograde esophageal dilation
Author(s) -
Fowlkes Jonathan,
Zald Philip B.,
Andersen Peter
Publication year - 2012
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.21826
Subject(s) - medicine , esophageal stricture , gastrostomy , head and neck cancer , esophageal cancer , surgery , feeding tube , gastrostomy tube , cancer , esophagus , radiation therapy
Background Complete esophageal stricture is a difficult problem to manage. There is limited literature to support clinical decision‐making. To evaluate outcomes and efficacy, we performed a retrospective medical chart review of patients who received combined anterograde retrograde esophageal dilation (CARD) between 2002 and 2009 at our institution. Methods Fifteen patients were identified who developed a stricture requiring CARD after treatment for head and neck cancers. Outcomes were pretreatment and posttreatment diet, gastrostomy tube status, and operative complications. Results Six of 15 patients were gastrostomy tube‐free at last follow‐up and 11 of 15 patients were taking oral nutrition. There were 4 complications. One patient died. Two gastrostomy tube site complications occurred. One patient sustained a dental injury. Conclusion CARD offers benefit to most patients. Despite risks associated with the procedure, CARD should be considered by the clinician and patient in management of complete esophageal stricture. © 2011 Wiley Periodicals, Inc. Head Neck , 2011