To evaluate the safety and efficacy of endoscopic dilation combined with bleomycin injection for anastomotic benign stricture after esophageal surgery.

A total of 55 patients with anastomotic benign stricture after esophageal surgery were retrospectively analyzed. Twenty-five patients received endoscopic dilation combined with bleomycin injection (endoscopic dilation combined with bleomycin group), and 30 patients received endoscopic dilation treatment alone (endoscopic dilation group). The time needed to alleviate esophageal stenosis, cost of dilation-related treatment, stenosis-free survival and complications were compared between the two groups.

Both groups of patients successfully completed endoscopic therapy and achieved endoscopic and clinical remission in a short period of time after treatment. There were no serious postoperative complications in the two groups, and there was no statistically significant difference in the incidence of postoperative complications between the two groups [8.0% (2/25) vs. 6.7% (2/30), χ²=0.046, P=0.83]. During the 1-year follow-up, patients in the endoscopic dilation combined with bleomycin group had a longer survival time without stenosis than that in the endoscopic dilation group [(11.1±0.4) months vs. (3.9±0.2) months]. Moreover, the median numbers of dilation required to resolve esophageal stenosis [1 (1, 2) vs. 3 (3, 4)] and dilation-related cost [$5791.2 (4987.4, 9974.8) vs. $16084.0 (14036.1, 19094.0)] were both significantly lower in the endoscopic dilation combined with bleomycin group than those in the endoscopic dilation group. There were statistically significant differences (χ²=54.322, Z=7.103, 6.653, all P<0.01).

Endoscopic dilation combined with bleomycin injection for benign anastomotic stenosis after esophageal surgery is more effective than endoscopic dilatation alone, which can prolong the stenosis -free survival time and reduce the number of dilation.