Mucosal Incision-assisted Balloon Dilation for Severe Radiation-associated Esophagogastric Anastomotic Stenosis after Chemoradiotherapy for Recurrent Esophageal Squamous Cell Carcinoma: A Case Report

Radiation-associated anastomotic stenosis is often rigid and poorly distensible, rendering conventional dilation hazardous. We report a case of a 67-year-old man who developed severe esophagogastric anastomotic stenosis after chemoradiotherapy for local recurrence following subtotal esophagectomy for esophageal squamous cell carcinoma. Endoscopy revealed a pinhole-like lumen. Four superficial mucosal incisions were made with a needle knife, followed by graded balloon dilation and an intralesional triamcinolone injection. Repeat dilation, performed one week later, increased the lumen to 12 mm. No adverse events occurred, and luminal patency with an improved oral intake was maintained for one month. This approach may therefore be feasible in high-risk patients.