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01-12-2021 | Endoscopy | Original Article

Outcomes of Combined Antegrade–Retrograde Dilations for Radiation-Induced Esophageal Strictures in Head and Neck Cancer Patients

Authors: Derek Liu, Trevor Pickering, Niels Kokot, Peter Crookes, Uttam K. Sinha, Mark S. Swanson

Published in: Dysphagia | Issue 6/2021

Abstract

The purpose of this study is to analyze outcomes of combined antegrade–retrograde dilations (CARD). This retrospective study was conducted on 14 patients with a history of head and neck cancer, treated with radiation therapy that was complicated by either complete or near-complete esophageal stenosis. All patients had minimal oral intake and depended on a gastrostomy tube for nutrition. Swallow function before and after CARD was assessed using the Functional Oral Intake Scale, originally developed for stroke patients and applied to head and neck cancer patients. Patients undergoing CARD demonstrated a quantifiable improvement in swallow function (p = 0.007) that persisted at last known follow-up (p = 0.015) but only a minority (23.1%) achieved oral intake sufficient to obviate the need for tube feeds. Complication rates were 24% per procedure or 36% per patient, almost all complications required procedural intervention, and all complications occurred in patients with complete stenosis. Our study suggests further caution when considering CARD, careful patient selection, and close post-operative monitoring.

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Title: Outcomes of Combined Antegrade–Retrograde Dilations for Radiation-Induced Esophageal Strictures in Head and Neck Cancer Patients
Authors: Derek Liu
Trevor Pickering
Niels Kokot
Peter Crookes
Uttam K. Sinha
Mark S. Swanson
Publication date: 01-12-2021
Publisher: Springer US
Keywords: Endoscopy
Radiotherapy
Dysphagia
Dysphagia
Dysphagia
Published in: Dysphagia / Issue 6/2021
Print ISSN: 0179-051X
Electronic ISSN: 1432-0460
DOI: https://doi.org/10.1007/s00455-020-10236-6

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Outcomes of Combined Antegrade–Retrograde Dilations for Radiation-Induced Esophageal Strictures in Head and Neck Cancer Patients

Abstract

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Abstract

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