Benign luminal obstruction of the gastrointestinal tract and airway arises from multiple causes, including peptic ulcer disease, caustic injury, postoperative strictures, inflammatory disorders, and tuberculosis-related airway stenosis [1–3]. Endoscopic balloon dilatation (EBD) is a minimally invasive, organ-preserving treatment with reported success rates of 81–100% for benign gastrointestinal strictures [12] and 65–89% for benign airway stenosis, avoiding surgery in ~65% of pediatric cases [13]. However, long-term EBD outcomes have not been reported in Mongolia, where gastric cancer (~20.3/100,000) [8], esophageal cancer (~18.5/100,000) [10], and Helicobacter pylori prevalence (~80%) [9] remain high. This study evaluates EBD technical and clinical success, refractory stricture rates, balloon-diameter progression, and safety.

A retrospective review was conducted on patients who underwent EBD for benign gastrointestinal or airway/anastomotic strictures from January 2022 to December 2025. Data collected included demographics, etiology, stricture location, balloon diameters (first and last), number of sessions, interval between dilatations, and adjunctive therapy use [4]. Procedural success was defined as successful passage of the endoscope after dilation [5]. Clinical success was defined as symptom resolution lasting >1 month with easy passage of a standard gastroscope [1]. Refractory strictures were defined as failure to achieve procedural success after five sessions [3].

Fifty-one patients were included (mean age 55.6 years; 51% male). Etiologies were peptic/ulcer-related disease (n=13), postoperative strictures (n=12), iatrogenic injury (n=10), radiation injury (n=3), and other benign causes such as TB-related airway/anastomotic stenosis (n=13). Stricture locations included the esophagus (n=15), gastric outlet (n=8), duodenum (n=2), and anastomotic or airway-related sites (n=26). Procedural and clinical success were achieved in all patients (100%).

Seven patients (13.7%) had refractory strictures, but all responded after adjunctive therapy. One perforation occurred (1.96%). The median initial and final balloon diameters were 20 mm (IQR 18–20) and 20 mm (IQR 19.5–20), respectively. Median diameter gain was 2 mm (mean 1.35 mm), with most patients undergoing conservative 2–3 mm incremental dilations consistent with safety-based protocols [4,12,13].

Table 2. Balloon Dilation Parameters and Outcomes

EBD is a safe and highly effective treatment for benign luminal obstruction of both gastrointestinal and airway structures, achieving excellent technical and clinical success. Gradual balloon expansion using 1–3 mm increments was well tolerated and aligned with internationally recognized safety protocols. Although refractory strictures occurred in a minority of cases, most responded to adjunctive modalities such as repeated dilation, steroid injection, incisional therapy, or temporary stenting. Further investigation is needed to determine optimal management strategies and to compare the effectiveness of each adjunctive modality.