Endoscopic dilation of benign esophageal strictures without fluoroscopy: experience of 2750 procedures. 2008

Ricardo Raymondi, and Júlio C Pereira-Lima, and Alexandro Valves, and Gustavo F Morales, and Daniela Marques, and César Vivian Lopes, and Cláudio A Marroni
Department of Gastroenterology and Hepatology, Santa Casa University Hospital of the Porto Alegre School of Medical Sciences (FFFCMPA), Brazil.

OBJECTIVE To report a large series of patients with strictures from different etiologies who underwent dilation without fluoroscopy. METHODS Between 1992 and 2005, 321 patients who underwent 2750 dilation sessions were entered in a database. Dysphagia score, cause and location of the stricture and diameter of the bougies were recorded in every session. RESULTS The mean follow-up period was 18.8 months. Stricture was postsurgical in 204 patients, peptic in 60, caustic in 13, postradiotherapy in 13, and from other causes in 31. Clinical response was achieved in 92% of the postsurgical patients; 84% of the caustic injuries; 81% of the peptic patients; and 58% of the radiation injuries (p < 0.05). Absence of dysphagia was obtained in 68, 38, 67 and 27% of these, respectively (p < 0.05). All groups showed a significant improvement in dysphagia score, and 98% of patients in whom a 45F catheter was inserted, achieved clinical response. There were 6 perforations, with 2 deaths. CONCLUSIONS Endoscopic dilation for benign esophageal strictures without fluoroscopy is safe and effective. Postsurgical patients show excellent results for dilation, and caustic and post-radiotherapy strictures have the worst response. A diameter of 45F is a satisfactory end-point for therapy in the majority of cases.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D002404 Catheterization Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from INTUBATION in that the tube here is used to restore or maintain patency in obstructions. Cannulation,Cannulations,Catheterizations
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D003680 Deglutition Disorders Difficulty in SWALLOWING which may result from neuromuscular disorder or mechanical obstruction. Dysphagia is classified into two distinct types: oropharyngeal dysphagia due to malfunction of the PHARYNX and UPPER ESOPHAGEAL SPHINCTER; and esophageal dysphagia due to malfunction of the ESOPHAGUS. Dysphagia,Swallowing Disorders,Esophageal Dysphagia,Oropharyngeal Dysphagia,Deglutition Disorder,Disorders, Deglutition,Dysphagia, Esophageal,Dysphagia, Oropharyngeal,Swallowing Disorder
D004940 Esophageal Stenosis A stricture of the ESOPHAGUS. Most are acquired but can be congenital. Esophageal Stricture,Stenosis, Esophageal,Esophageal Stenoses,Stricture, Esophageal
D005260 Female Females
D005471 Fluoroscopy Production of an image when x-rays strike a fluorescent screen. Fluoroscopies
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths

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