Comparative study of self-expandable stent placement, bougie dilation, and balloon dilation for post-inflammatory oesophageal strictures

doi:10.4253/wjge.v18.i3.117303

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World Journal of Gastrointestinal Endoscopy

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World J Gastrointest Endosc. Mar 16, 2026; 18(3): 117303
Published online Mar 16, 2026. doi: 10.4253/wjge.v18.i3.117303

Comparative study of self-expandable stent placement, bougie dilation, and balloon dilation for post-inflammatory oesophageal strictures

Hui-Feng Yuan, Ping Liu, Chang-Qing Guo, Yong-Hua Bi

Hui-Feng Yuan, Yong-Hua Bi, Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China

Ping Liu, Chang-Qing Guo, Department of Gastroenterology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China

Author contributions: Yuan HF, Liu P and Bi YH participated in the conception and design of the study and were involved in the acquisition, analysis, or interpretation of data; Guo CQ wrote the manuscript; Bi YH and Guo CQ accessed and verified the study data; all authors critically reviewed and provided final approval of the manuscript; all authors were responsible for the decision to submit the manuscript for publication.

Institutional review board statement: This investigation was approved by the Institutional Review Board of the First Affiliated Hospital of Zhengzhou University (No. 2023-KY-1378).

Informed consent statement: The need for patient consent was waived due to the retrospective nature of the study.

Conflict-of-interest statement: The authors declare no conflicts of interest.

Data sharing statement: The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

Corresponding author: Yong-Hua Bi, MD, PhD, Professor, Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe Dong Road, Zhengzhou 450052, Henan Province, China. 274233911@qq.com

Received: December 4, 2025
Revised: December 21, 2025
Accepted: January 21, 2026
Published online: March 16, 2026
Processing time: 99 Days and 15 Hours

Abstract

BACKGROUND

The outcomes of self-expandable metal stent (SEMS) placement, bougie dilation and balloon dilation for the management of post-inflammatory oesophageal strictures (PIESs) have not been compared previously.

AIM

To compare the safety, effectiveness and cost-effectiveness of SEMS placement, bougie dilation and balloon dilation in patients with PIESs.

METHODS

The medical records of 58 patients with PIESs who underwent SEMS placement with or without dilation (stent group), bougie dilation (bougie group) or balloon dilation (balloon group) between September 2014 and February 2025 at the Gastrointestinal and Interventional Centre of our hospital were retrospectively reviewed. Clinical outcomes, including safety, effectiveness and cost-effectiveness, were compared among the three groups.

RESULTS

The technical success rates were 81.5%, 81.1% and 77.4%, and the clinical success rates were 62.5% (10/16), 70.0% (14/20) and 81.0% (17/21) in the stent, bougie and balloon groups, respectively. After the procedures, the stricture diameter increased significantly and symptom scores decreased significantly in all three groups. The cumulative costs were 2.5 × 10⁴ ¥, 2.6 × 10⁴ ¥ and 11.5 × 10⁴ ¥ in the bougie, balloon and stent groups, respectively. Perforation was the only major complication. Longer hospital stays and more frequent hospitalisations were observed in the stent group. Mild bleeding and chest pain were the most common minor complications. Stent-related complications occurred in eight patients during 17 procedures.

CONCLUSION

Bougie and balloon dilation are safe, effective and cost-efficient treatments for PIESs. Treatment of PIESs with SEMSs should be undertaken with caution because of the high cumulative costs, prolonged hospital stays, frequent hospitalisations and stent-related complications.

Keywords: Benign oesophageal strictures; Bougies dilators; Balloon dilation; Stents; Peptic stricture

Core Tip: This is a retrospective single-center observational study to investigate the safety, effectiveness and cost-effectiveness of self-expandable metal stent (SEMS) placement, bougie dilation, and balloon dilation for patients with post-inflammatory oesophageal strictures (PIESs). Bougie and balloon dilation are safe, effective and cost-efficient treatments for PIESs. However, treatment of PIESs with SEMSs should be undertaken with caution because of the high cumulative costs, prolonged hospital stays, frequent hospitalisations and stent-related complications.