Dilation of proximal esophageal strictures following therapy for head and neck cancer: experience with Savary Gilliard dilators

J Surg Oncol. 1996 Nov;63(3):187-90. doi: 10.1002/(SICI)1096-9098(199611)63:3<187::AID-JSO10>3.0.CO;2-2.

Abstract

Background: There is little information on dilation of proximal strictures following surgical and/or radiation therapy for head and neck cancer. We studied the feasibility and efficacy of dilating proximal strictures following therapy for head and neck cancer using Savary Gilliard dilators.

Methods: Twenty-one consecutive patients with proximal strictures resulting from surgery and/or radiation therapy of head and neck cancer were studied. Savary Gilliard dilation was performed using the standard and a modified method. Dysphagia was graded before and after dilation using a 5-point scale.

Results: Technical success, dysphagia relief, complications, and duration of relief were noted. Technical success was achieved in 20 (95%) patients. Adequate dysphagia relief was obtained in 15/20 (75%) patients, which lasted for 4-36 weeks (median 14 weeks). There were no perforations, bleeding, or deaths. Four patients required repeat dilation after a median interval of 12 weeks.

Conclusions: Savary Gilliard dilation is a safe and effective method for dilating strictures caused by therapy for head and neck cancer.

MeSH terms

  • Adult
  • Aged
  • Constriction, Pathologic / etiology
  • Constriction, Pathologic / therapy
  • Deglutition Disorders / etiology
  • Deglutition Disorders / therapy*
  • Dilatation / instrumentation*
  • Esophagus / pathology*
  • Esophagus / radiation effects
  • Female
  • Follow-Up Studies
  • Head and Neck Neoplasms / radiotherapy
  • Head and Neck Neoplasms / surgery
  • Head and Neck Neoplasms / therapy*
  • Humans
  • Male
  • Middle Aged
  • Radiotherapy, Adjuvant
  • Treatment Outcome