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Oesophageal II
PWE-025 Post-radiotherapy pharyngeal/proximal oesophageal strictures in head and neck malignancy: outcome of endoscopic bougie dilation
  1. R Sringeri1,
  2. L Priestnall2,
  3. R Cullen3,
  4. N C Fisher1
  1. 1Department of Gastroenterology, Birmingham, UK
  2. 2Speech and Language Therapy Department, Birmingham, UK
  3. 3ENT, The Dudley Group NHS Foundation Trust, Birmingham, UK

Abstract

Introduction Chemo-radiotherapy is the standard of care for most patients with head and neck malignancy. Radiotherapy may lead to dysphagia due to pharyngeal/proximal oesophageal strictures. Endoscopic management of these strictures with antegrade dilation by using Savary Gilliard bougie dilators is described in literature.1 2 Our aim was to review the outcome in patients referred for bougie dilation for radiotherapy induced strictures.

Methods It is a retrospective case notes review.

Results 11 patients underwent bougie dilation of radiotherapy induced strictures in last 4 years. Nine male, two female patients with median age of 71 years. Five patients had laryngeal cancer and six had oropharyngeal cancer. All patients had radiotherapy where four had concurrent chemotherapy. Five patients required flouroscopy and seven patients required nase endoscope. Median size of initial bougie size was 11 mm and final bougie size was 17 mm. Mean number of procedures per patient was 4. No complications noted. While three patients had good response, six had borderline and two had none. Median interval from completion of radiotherapy to index procedure was 2.5 years with range from 2 months to 12 years.

Conclusion Savary Gilliard bougie dilation appears to be safe and well tolerated method for dilating pharyngeal/proximal oesophageal strictures secondary to radiotherapy treatment for head and neck cancer. While symptom improvement varied among patients probably early intervention might benefit the patient.

Competing interests None declared.

References 1. Ahlawat SK, Al-Kawas FH. Endoscopic management of upper esophageal strictures after treatment of head and neck malignancy. Gastrointest Endosc 2008;68:19–24.

2. Dhir V, Vege SS, Mohandas KM, et al. Dilation of proximal esophageal strictures following therapy for head and neck cancer: experience with Savary Gilliard dilators. J Surg Oncol 1996;63:187–90.

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