Do Steroid Injections Work for Esophagogastric Anastomotic Strictures?

The clinical management of benign persistent anastomotic strictures of the esophagus is often challenging. Corticosteroid injection coupled with dilation has been shown to be effective in refractory peptic strictures, but does it work for anastomotic strictures?

In a multicenter, double-blind trial, 60 patients with solid-food dysphagia and an untreated cervical esophagogastric anastomotic stricture after esophagectomy were randomized to receive triamcinolone or saline injection. For mild strictures, dilation to 16 mm was usually achieved in a single endoscopy. For more severe strictures, ≥2 endoscopies within 1 week were performed. If dilation to 16 mm was deemed safe, 0.5-mL aliquots of triamcinolone (40 mg/mL) or saline were injected into…