Endoscopic dilation of benign esophageal strictures: report on 1043 procedures. 1999

J C Pereira-Lima, and R P Ramires, and I Zamin, and A P Cassal, and C A Marroni, and A A Mattos
Department of Gastroenterology, Santa Casa University Hospital, Porto Alegre Medical School, Brazil.

OBJECTIVE Endoscopic dilation is considered the best treatment for most cases of benign esophageal stricture, although the best dilation technique and the kind of stricture is the most amenable to treatment is still controversial. We report on our experience on a large series of patients treated by dilation without the aid of fluoroscopy and compare the results of this therapy among patients with strictures from different causes. METHODS Between 1992 and 1997, we performed 1043 dilation sessions on 153 patients. Treatment was considered adequate if the esophageal lumen could be dilated up to the size of a 42F catheter. If the stricture recurred after initial successful treatment, the stricture was dilated again up to a 42F catheter. RESULTS One hundred forty patients (96 men, 44 women; mean age, 54.1 yr) were followed-up for a mean of 20.5 months (4 to 62 months). Stricture's etiology was postsurgical in 80 patients, peptic in 37, caustic in 12, and from other causes in 11 patients. Adequate dilation was achieved in 93.5% of the patients (131 of 140). Patients with peptic strictures needed a median of three sessions to be adequately dilated during follow-up in comparison to five sessions among patients with postsurgical or caustic strictures (p = 0.07). There were four perforations, with one death (2.8% and 0.7% per patient and 0.4% and 0.1% per session, respectively). CONCLUSIONS Endoscopic dilation without the aid of fluoroscopy is safe and effective in relieving dysphagia caused by benign strictures of different causes, although repeated sessions are necessary because of stricture recurrence.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D004106 Dilatation The act of dilating. Dilation,Dilatations,Dilations
D004940 Esophageal Stenosis A stricture of the ESOPHAGUS. Most are acquired but can be congenital. Esophageal Stricture,Stenosis, Esophageal,Esophageal Stenoses,Stricture, Esophageal
D004945 Esophagoscopy Endoscopic examination, therapy or surgery of the esophagus. Esophagoscopic Surgical Procedures,Surgical Procedures, Esophagoscopic,Esophagoscopic Surgery,Surgery, Esophagoscopic,Esophagoscopic Surgeries,Esophagoscopic Surgical Procedure,Esophagoscopies,Procedure, Esophagoscopic Surgical,Procedures, Esophagoscopic Surgical,Surgeries, Esophagoscopic,Surgical Procedure, Esophagoscopic
D004947 Esophagus The muscular membranous segment between the PHARYNX and the STOMACH in the UPPER GASTROINTESTINAL TRACT.
D005260 Female Females

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