Refractory esophageal stenosis after endoscopic submucosal dissection for esophageal cancer managed with multiple...

Esophageal cancer is a clinically common malignant tumor of the digestive system. In 2022, it ranked fifth among the leading causes of cancer-related deaths in China. Its predominant symptom is dysphagia, and approximately 30%-40% of patients are prone to developing postoperative recurrent stenosis, necessitating repeated esophageal dilation, which significantly affects patients' quality of life. The self-dilation technique, performed by patients, enables preventive esophageal dilation and aims to reduce the frequency of recurrent stenosis.

We report the case of a 61-year-old man who underwent repeated esophageal dilations following endoscopic submucosal dissection. During his eighth hospital admission, a multidisciplinary management team was established to implement an evidence-based self-help balloon dilation technique, facilitate early identification of nursing concerns and complications, and provide transitional care following discharge. The patient reported a high level of satisfaction during the hospital stay. During the 6-month follow-up after discharge, the patient's quality of life improved, with a substantial reduction in dysphagia. The esophageal stricture was successfully dilated from 5 mm to 6 mm, the interval between readmissions was prolonged, and the patient's weight increased from 49 kg to 50 kg.

The establishment of a multidisciplinary case management team, combined with the implementation of a self-help balloon dilation technique, early identification and management of nursing issues and complications, and personalized extended care, can significantly enhance patient satisfaction during hospitalization, improve quality of life, and extend the interval between readmissions. These strategies can provide valuable practical guidance for the clinical treatment and nursing of patients with recurrent esophageal stenosis.