I. Overview Esophageal stricture refers to the narrowing of the lumen of the esophagus caused by disease of the esophagus itself or by external pressure, which mainly manifests as difficulty in swallowing and affects eating. The common causes of esophageal stenosis are: esophageal mucosa damage due to inflammation or chemical corrosion and scar formation after repair; esophageal tumors such as esophageal cancer that block the lumen of the esophagus to varying degrees; esophageal stenosis caused by external pressure on the esophagus from surrounding tissue lesions, such as lung and mediastinal tumors, aneurysms, goiter, etc. In mild cases, it is characterized by foreign body sensation or food retention in eating, while in severe cases, it is characterized by difficulty in swallowing, even difficulty in drinking, food reflux, and then malnutrition such as dehydration, weakness, emaciation, and peripheral edema caused by hypoproteinemia. The diagnosis of esophageal stricture is not difficult based on clinical manifestations such as dysphagia, combined with barium x-ray and endoscopy. If CT, MRI and other imaging examinations are performed at the same time, the cause of esophageal stricture can be confirmed. Treatment (a) For benign esophageal strictures: such as those caused by chemical burns and scars in the esophagus 1. For benign esophageal strictures, the only treatment in the past was surgery, i.e., resection of the strictured section of the esophagus through a dissecting incision, followed by end-to-end esophageal anastomosis. Patients suffer a lot, the cost is high, and there are many postoperative complications. For benign esophageal stenosis, balloon dilation is mostly used. For benign stenosis of the gastroesophageal anastomosis, anti-reflux stents can be placed to block the reflux of gastric contents when the dilation effect is poor. The method is to deliver the balloon to the esophageal stenosis through the mouth under fluoroscopy for dilation and, if necessary, placement of a stent. This method is less painful for the patient, less costly, faster recovery, and fewer postoperative complications. (2) For malignant esophageal stricture: such as esophageal stricture caused by esophageal cancer 1. Surgery: It is the preferred treatment for esophageal cancer or high esophageal obstruction, and posterior sternal colon can be considered in place of esophagus and radiotherapy can be given afterwards. It is characterized by thorough treatment, but it is traumatic, expensive, slow recovery and narrow indication, such as cardiopulmonary insufficiency or old and frail people may not be able to tolerate the surgery. 2.Radiotherapy: Except for esophageal perforation forming esophageal fistula, distant metastasis, obvious malignancy, serious heart, lung and liver diseases, radiotherapy can be performed for esophageal cancer, but it cannot solve the problem of esophageal stricture in a short time, and at the same time, complications such as esophage-tracheal fistula and esophage-mediastinal fistula may occur in radiotherapy. 3.Chemotherapy: chemotherapy drugs have poor efficiency in esophageal cancer, cisplatin and pinyamycin are more commonly used, but the long-term efficacy is not ideal. They also cannot lift esophageal stricture in a short time. 4.Interventional treatment: if the malignant esophageal stricture severely affects feeding, esophageal stent placement is feasible; if the stricture is located in the cardia of lower esophagus, anti-reflux stent can be placed; if combined with esophage-tracheal fistula or esophage-mediastinal fistula, overlapping stent can be placed; if treatment for esophageal cancer is needed while relieving esophageal stricture, esophageal stent with radioactive particles (iodine-125) with membrane can be placed. (c) For external pressure esophageal strictures: such as lung and mediastinal tumors, aneurysms, goiter, etc. For external compression esophageal strictures, treatment of the primary lesion is usually all that is needed to relieve the compression, but if the patient is in poor health and cannot immediately tolerate surgery or radiation therapy for the primary lesion, a retrievable esophageal stent may be considered first, and then the stent may be removed after the primary lesion is treated. In contrast, interventional treatment can immediately relieve esophageal strictures, which is less expensive, less invasive, less painful, less risky, and more effective, and can rapidly solve the patient’s dietary problems, rapidly eliminate symptoms, improve immunity, and restore physical fitness. It is also able to treat malignant lesions, solving the drawbacks of surgical treatment such as high trauma and serious systemic toxic side effects of radiotherapy, and has been more and more widely accepted by patients.