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

Table 1 Clinical characteristics of enrolled patients, n (%)/mean ± SD

	Stent group	Bougie group	Balloon group	P value
Number of patients	16	20	22
Gender (male)	12 (75.0)	14 (70.0)	16 (72.7)	0.9451
Mean age, years	58.1 ± 19.4	61.7 ± 17.0	60.5 ± 16.3	0.8270
Symptom duration (months)	6.0 (2.0, 12.0)	9.0 (5.3, 24.0)	11.0 (0.6, 24.0)	0.4413
Stricture causes				0.2942
Peptic ulcer disease	7 (43.7)	4 (20.0)	4 (18.2)
Reflux esophagitis	4 (25.0)	6 (30.0)	10 (45.4)
Others1	5 (31.3)	10 (50.0)	8 (36.4)
Degree of stricture				0.3193
Severe stricture	14 (87.5)	12 (60.0)	16 (72.7)
Moderate stricture	2 (12.5)	7 (35.0)	4 (18.2)
Mild stricture	0 (0.0)	1 (5.0)	2 (9.1)
Location of stricture				0.2910
Cervical and upper esophagus	3 (18.8)	8 (40.0)	7 (31.8)
Middle and lower esophagus	4 (25.0)	2 (10.0)	1 (4.5)
Lower esophagus and cardia	9 (56.3)	10 (50.0)	14 (63.6)
Stricture type				0.1446
Focal strictures or not evaluated	3 (18.8)	6 (30.0)	6 (27.3)
Segmental strictures	3 (18.8)	9 (45.0)	10 (45.5)
Long strictures	10 (62.5)	5 (25.0)	6 (27.3)

¹Other inflammatory esophagitis include fungal esophagitis, syphilitic esophagitis, and chronic oesophageal mucosal inflammation.

Table 2 Technical outcomes, hospitalisation and stricture change, n (%)/median (25^th-75^th percentiles)/mean ± SD

	Stent group	Bougie group	Balloon group	P value
Sessions of dilations	79	53	62
Technical success	110 (81.5)	43 (81.1)	48 (77.4)	0.5466
Sessions of stenting	56
Median sessions of dilations	5.0 (2.3-5.8)	2.0 (1.0-3.0)	2.0 (1.0-4.0)	0.0818
Cumulative hospital stay (days)	52.2 (25.3-75.7)	12.0 (7.0-19.0)	14.0 (9.8-32.9)	0.0001
Average hospital stay (days)	7.3 (3.2-10.1)	5.1 (3.4-7.0)	6.7 (4.8-11.0)	0.0620
Cumulative cost (× 104 ¥)	11.5 (8.1-17.1)	2.5 (1.2-3.9)	2.6 (1.9-5.1)	< 0.0001
Average costs (× 104 ¥)	1.7 ± 0.6	1.1 ± 0.7	1.6 ± 0.7	0.0507
Numbers of hospitalisations	7.0 (5.5-11.0)	2.0 (1.0-3.0)	2.0 (1.0-5.0)	< 0.0001
Procedure time, minutes	37.0 (24.8-45.5)	40.0 (30.5-57.5)	35.0 (30.0-52.5)	0.0763
Treatment duration, months	14.6 (7.3-33.9)	13.7 (4.4- 17.7)	3.9 (0.4-33.2)	0.1854
Initial dilation size, mm	14.4 ± 3.0	13.3 ± 2.5	13.5 ± 3.2	0.5138
Sessions per visit	1.2 ± 0.4	1.1 ± 0.3	1.2 ± 0.4	0.6241
Dilation interval, months	2.3 (1.2-7.1)	6.2 (1.4-9.7)	4.4 (1.4-13.8)	0.4418
Stricture rate (%)
Before dilation	82.9 (77.8-88.9)	80.4 (70.8-91.4)	80.6 (65.9-93.4)	0.5931
Post-dilation	49.8 (37.4-63.5)c	63.9 (40.2, 87.5)	55.6 (39.6-68.8)c	0.6305
Dysphagia score
Before dilation	2.7 ± 1.1	2.3 ± 1.0	2.4 ± 0.7	0.4009
Post-dilation	1.4 ± 1.5b	1.2 ± 1.4a	1.0 ± 1.5c	0.7309
Mean diameter of stricture, mm
Before dilation	3.6 ± 1.9	4.1 ± 2.0	4.0 ± 2.6	0.5713
Post-dilation	11.1 ± 5.7c	6.0 ± 6.4a	8.1 ± 3.9c	0.1048
Mean length of stricture, mm
Before dilation	34.9 (20.6-49.4)	20.0 (13.4-46.5)	23.9 (16.3-45.2)	0.2004
Post-dilation	19.9 (0.0-29.5)c	18.0 (9.4-61.0)	20.0 (0.0-25.3)a	0.5526

^aP < 0.05 vs before dilation.

^bP < 0.01 vs before dilation.

^cP < 0.0001 vs before dilation.

Table 3 Complications, clinical outcomes and follow-up, n (%)/median (25^th-75^th percentiles)

	Stent group	Bougie group	Balloon group	P value
Complications
Mild bleeding	12 (75.0)	14 (70.0)	20 (90.0)	0.2186
Mild chest pain	5 (31.3)	1 (5.0)	4 (18.2)	0.1156
Esophageal ruptures	2 (12.5)	0 (0.0)	2 (9.1)	0.2969
Stent migration	6 (37.5)
Stent restenosis	4 (25.0)
Stent intolerance	4 (25.0)
Median follow-up (months)	43.7 (23.3-103.0)	30.6 (18.9-66.8)	40.7 (27.3-66.7)	0.1818
Clinical outcomes				0.4095
Complete cure	4 (25.0)	8 (40.0)	12 (57.1)
Improved	6 (37.5)	6 (30.0)	5 (23.8)
Ineffective	6 (37.5)	6 (30.0)	4 (19.0)
Lost to follow up	0 (0.0)	0 (0.0)	1 (4.5)	0.4349
5-year survival rate	84.4	87.7	76.2	0.6151