Benign esophageal strictures : endoscopic treatment options

Bening strictures of the esophagus are a frequently encountered problem in endoscopy. Dilation by Savary-Gilliard dilators or balloon dilators is the first line treatment and relieves dysphagia in about 75 % of cases. Complex strictures are at higher risk of treatment failure than simple ones and are considered as refractory after repetitive unsuccessful dilations. Adjunction of locally injected corticoids favors outcome in strictures of peptic origin. Further treatment options of refractory strictures are endoscopic incision therapy in short ones and temporary self expandable metallic (SEMS), plastic (SEPS) or biodegradable stent insertion in complex ones. Ultimate rescue treatment consists in self bouginage or esophageal surgery.