Research progress in endoscopic treatment of benign esophageal anastomotic stricture

Huang Qiqiang; Zhang Ciqian; Zhuang Zehao

doi:10.16689/j.cnki.cn11-9349/r.2026.01.006

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Electronic Journal of Metabolism and Nutrition of Cancer ›› 2026, Vol. 13 ›› Issue (1) : 32-37. DOI: 10.16689/j.cnki.cn11-9349/r.2026.01.006

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Research progress in endoscopic treatment of benign esophageal anastomotic stricture

¹Huang Qiqiang, ²Zhang Ciqian, ²Zhuang Zehao

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Abstract

Benign esophageal anastomotic stricture (BEAS) is a common complication following esophageal surgery, clinically manifested as progressive dysphagia, which severely affects nutritional intake and quality of life. The development of BEAS involves persistent local inflammatory responses at the anastomotic site, excessive fibroblast activation, and abnormal collagen deposition, leading to tissue hyperplasia and luminal narrowing. Endoscopic therapy, characterized by its minimally invasive nature, repeatability, and high safety profile, has become the first-line treatment for BEAS. Therapeutic strategies include various techniques used alone or in combination, such as endoscopic balloon or bougie dilation, stricture incision, stent placement, and local drug application. Balloon and bougie dilation show comparable efficacy and complication rates. Achieving a final dilation diameter of ≥15 mm helps reduce recurrence, whereas exceeding 25 mm may increase the risk of perforation. For refractory or recurrent strictures (defined as diameter <14 mm after five dilation sessions), dilation alone is often insufficient. Endoscopic incision allows targeted resection of scar tissue, particularly suitable for short-segment, fibrotic strictures, and demonstrates a lower restenosis rate compared to dilation alone. Various types of stents have been developed to rapidly relieve obstruction; however, issues such as migration, tissue hyperplasia, and high cost limit their use primarily to refractory cases. Adjuvant pharmacological therapies, such as local injection of corticosteroids or mitomycin C, may delay stricture recurrence by inhibiting fibrosis, though their efficacy remains controversial. Endoscopic treatment strategies should be individualized based on stricture characteristics, recurrence history, and the overall condition. This article reviews recent advances in endoscopic techniques for BEAS, focusing on the indications, efficacy, and safety of various endoscopic treatments, aiming to provide evidence-based guidance for optimizing clinical management, improving nutritional status.

Key words

Benign esophageal anastomotic stricture / Endoscopic therapy / Balloon dilation / Endoscopic incision / Esophageal stent / Local pharmacological therapy / Dysphagia / Nutritional access

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Huang Qiqiang, Zhang Ciqian, Zhuang Zehao. Research progress in endoscopic treatment of benign esophageal anastomotic stricture[J]. Electronic Journal of Metabolism and Nutrition of Cancer. 2026, 13(1): 32-37 https://doi.org/10.16689/j.cnki.cn11-9349/r.2026.01.006

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