European Journal of Cardio-Thoracic Surgery, Vol 3, 93-97, Copyright © 1989 by European Association for Cardio-thoracic Surgery
Management of proximal oesophageal stricture
K Moghissi and D Pender
Humberside Cardiothoracic Surgical Centre, Castle Hill Hospital, Cottingham, Hull, UK.
Thirty-two patients with proximal oesophageal stricture who were treated
under one surgeon (K.M.) during a 17-year period are reviewed. The cause of
the stricture in these cases was widely varied and included:
gastro-oesophageal reflux (Barrett-type oesophagus), radiotherapy and
post-surgical anastomosis following oesophageal reconstruction. Seventeen
patients were treated by repeated endoscopic dilatation. Of the remaining
15, 3 patients only (1 with suspected malignancy and 2 with occult cancer)
needed resection and reconstruction of the oesophagus. Twelve patients
underwent simple conservative operations. There was no hospital or
treatment related mortality in this series. We concluded that the majority
of such strictures respond to repeated endoscopic dilatation or
conservative surgical operation. It is mandatory to exclude malignancy in
obstructive lesions of the proximal oesophagus and it is important to
establish the aetiology of the lesion in order to undertake the most
appropriate treatment.
