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

Area of Science:

• Gastroenterology
• Interventional Endoscopy
• Esophageal Diseases

Background:

• Benign esophageal strictures (BESs) are commonly managed with antegrade Savary or static balloon dilation.
• Retrograde balloon dilation is a modified technique with potential advantages for BES management.
• Limited efficacy and safety data exist for retrograde balloon dilation.

Purpose of the Study:

• To evaluate the efficacy and safety of retrograde balloon dilation for benign esophageal strictures.
• To compare retrograde balloon dilation with antegrade Savary dilation in a single-center experience.

Main Methods:

• A retrospective study included 53 patients with BESs, comparing 23 undergoing retrograde balloon pull-through dilation and 30 undergoing antegrade Savary dilation.
• The primary endpoint was technical success (luminal diameter ≥16 mm).
• Secondary endpoints included repeat dilation rates within 1 year and adverse events.

Main Results:

• Technical success was high for both techniques: 95.7% for retrograde balloon pull-through and 100% for antegrade Savary dilation (P = .434).
• A trend towards lower repeat dilation rates was observed with retrograde balloon pull-through (4/22 vs. 12/30, P = .076).
• Only one minor adverse event was reported in the retrograde group.

Conclusions:

• Retrograde balloon pull-through dilation is effective and safe for managing both simple and complex benign esophageal strictures.
• This technique offers a viable alternative to traditional antegrade methods.
• Further research may confirm its potential to reduce retreatment rates.