NKI Therapy Compared to Usual Care of Recurrent Esophagogastric Anastomotic Strictures

Inclusion Criteria: * Recurrent intra- or extrathoracic benign esophagogastric anastomotic stricture after esophagectomy. The definition of a stricture is based on the Ogilvie Dysphagia score (severity of dysphagia), i.e. Ogilvie score ≥2 (= ability to swallow semi-solid food or worse (Appendix table 1)). * No patency for a standard endoscope (diameter \< 10 mm) * The recurrent stricture has been previously treated with at least 1 to a maximum of 5 EBD sessions that reached an esophageal diameter of ≥16 mm. * The stricture should be suitable for endoscopic incision (stricture length ≤10 mm). Exclusion Criteria: * Benign esophageal stricture other than an esophagogastric anastomotic stricture. * Strictures with a morphology unsuitable for NKI, such as long (\>1 cm), irregulair or tortuous strictures. * Previous endoscopic treatment of the esophageal stricture with steroid injection, incision therapy or stent placement within the past 3 months. * Previous stent placement post-esophagectomy for anastomotic leakage. * (Suspicion of) locally recurrent or metastasized esophageal cancer. * Persisting postoperative esophageal fistula. * Inability to discontinue anticoagulants or high-dose antiplatelet drugs at time of the baseline procedure. Low-dose aspirin (max. 100 mg/day) may be continued. * Known clotting disorder that cannot pre-procedural be corrected.