Retrograde Balloon Pull-Through Technique for Benign Esophageal Strictures: A Single Center Pilot Experience- (with Video)

Background and AimsAntegrade savary dilation and static balloon dilation are the mainstay of management of simple and complex benign esophageal strictures (BES). A modified technique, termed retrograde balloon dilation, has potential advantages for management of BES. Efficacy and safety data on this technique is limited. We report a single center experience of retrograde balloon dilation for BES.MethodsWe conducted a retrospective study evaluating retrograde balloon and antegrade savary dilation for BES. 53 unique patients met inclusion criteria including 23 undergoing retrograde balloon pull-through and 30 undergoing antegrade savary dilation. Primary endpoint was technical success, defined as achieving a luminal diameter of ≥ 16mm. Secondary endpoints include repeat dilation rates within one year after achieving therapeutic endpoint dilation and complications.ResultsTechnical success was achieved in 22/23 (95.7%) patients with retrograde balloon pull-through and 30/30 (100%) with antegrade savary dilation (p=0.434). A non-significant trend of lower repeat dilation rates was present for the retrograde balloon group – (4/22) retrograde balloon pull-through vs 12/30 in antegrade Savary dilation (p=0.076). Only one minor complication occurred in the retrograde balloon pull through group.ConclusionOur experience suggests retrograde balloon dilation is effective and safe for simple and complex benign esophageal stenosis.