Endoscopic treatment of severe esophageal strictures in children by combined proximal and distal approaches

1994 ◽  
Vol 9 (3) ◽  
Author(s):  
Akihiro Toyosaka ◽  
Eizo Okamoto ◽  
Akiyoshi Shu ◽  
Yousuke Yoden ◽  
Tatsuo Okasora ◽  
...  
Keyword(s):  
Endoscopic Treatment ◽  
Esophageal Strictures

PS01.095: BENIGN ESOPHAGEAL STRICTURE: A RECAP OF OUR EXPERIENCE

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 76-76
Author(s):  
Keat How Teoh ◽  
Kelvin Voon ◽  
Shyang Yee Lim ◽  
Premnath Nagalingam
Keyword(s):  
Endoscopic Treatment ◽  
Esophageal Stricture ◽  
Endoscopic Dilatation ◽  
Line Treatment ◽  
First Line ◽  
Benign Esophageal Stricture ◽  
Anastomotic Strictures ◽  
Esophageal Strictures ◽  
The Mean ◽  
First Line Treatment

Abstract Background Caustic injury remains the commonest cause of benign esophageal strictures in Asia. Others include gastroesophageal reflux, iatrogenic, radiation, autoimmune or idiopathic causes. Treatment goals are relief of dysphagia and prevention of recurrence. This study aims to evaluate the experience with benign esophageal stricture in Penang Hospital, a tertiary hospital in Northern region of Malaysia. Methods A retrospective review of 12 patients with benign esophageal strictures between year 2012 - 2017. Results The mean age was 53.5 and two thirds were female. Half of these patients were of Chinese ethnicity while the other half were Indian. The commonest cause was caustic ingestion (41.7%), followed by reflux stricture (25%) and anastomotic stricture (25%). There was one case of dystrophic epidermolysis bullosa. More than half of the patients had complex and multiple strictures. 41.7% of patients had proximal strictures that were located within 20cm from the incisors. Endoscopic dilatation was the first line treatment with either Savary Gilliard or balloon dilators. A total of 97 dilatation sessions were done with a mean dilatation frequency of 2.3 ± 1.5 times for anastomotic strictures, 8 ± 8.2 times for reflux strictures and 8.0 ± 6.6 times for corrosive strictures. The mean dilatation interval was 2.5 ± 1.2 weeks. 58.3% of patients had successful endoscopic treatment. The success rate was higher in non-corrosive stricture (83% vs 40%). There was one dilatation related complication in which the patient had pneumomediastinum without overt mediastinitis. This however, resolved with conservative management. 41.7% of patients had refractory strictures that failed endoscopic dilatation. Surgery including esophagectomy (40%), revision of anastomosis (20%) and gastrostomy (40%) were done for this group of patients. Proximal strictures, complex strictures and multiple strictures were associated with failed endoscopic dilatation (P < 0.05). Conclusion Endoscopic dilatation is the first line treatment for benign esophageal strictures. Surgery is reserved for refractory strictures with failed endoscopic treatment. Predictor scoring systems for refractory stricture and individualized approaches are the key to success. Disclosure All authors have declared no conflicts of interest.

scholarly journals Triple intramural dexamethasone injections increase the efficiency of endoscopic bougienage of esophageal re-stenosis and anastomosis

2021 ◽  
Vol 1 (5) ◽  
pp. 31-38
Author(s):  
N. A. Bulganina ◽  
E. A. Godzhello ◽  
M. V. Khrustaleva ◽  
M. A. Dekhtyar
Keyword(s):  
Satisfactory Result ◽  
Endoscopic Treatment ◽  
Research Center ◽  
Lumen Diameter ◽  
Standard Algorithm ◽  
Esophageal Strictures ◽  
Long Time ◽  
Biopsy Channel

Purpose of the study. To analyze retrospectively our own experience of using intramural dexamethasone injections during endoscopic bougienage of recurrent or very tight (refractory) benign cicatricial strictures of the esophagus and esophageal anastomoses.Materials and methods. From 2013 to March 2021, this method was applied in 43 patients (26 — men, 17 — women) with peptic (11), cicatricial (8), burn (6) esophageal strictures and strictures of anastomoses (18) prone to restenosis. Dexamethasone was injected into the constricted area with a needle passed through the endoscope biopsy channel as an addition to supportive bougienage.Results. After dexamethasone injections, 41 (95.3%) of 43 patients achieved a satisfactory lumen diameter, at which the symptoms of dysphagia disappeared for a long time without relapse. In most patients, the lumen in the stricture zone stabilized at a diameter of 8–18 mm (average 13 mm). With strictures of the esophagus, it was possible to achieve a diameter of 8–14 mm (average 11 mm), and with strictures of the anastomoses — 10–18 mm (average 14 mm).Conclusion. With the tendency of stricture to restenosis, the standard algorithm for endoscopic bougienage, developed in the endoscopy department of the “Petrovsky National Research Center of Surgery”, was supplemented with intramural injections of dexamethasone. This combined endoscopic treatment made it possible to increase the diameter of the bougie and the intervals between bougienage due to the stabilization of the scar frame and to complete the endoscopic treatment with a satisfactory result in 95.3% of patients.

scholarly journals Management of esophageal strictures after endoscopic resection for early neoplasia

2021 ◽  
Vol 14 ◽  
pp. 175628482098529
Author(s):  
Einas Abou Ali ◽  
Arthur Belle ◽  
Rachel Hallit ◽  
Benoit Terris ◽  
Frédéric Beuvon ◽  
...  
Keyword(s):  
Endoscopic Resection ◽  
Endoscopic Treatment ◽  
Esophageal Stricture ◽  
Rare Event ◽  
Median Number ◽  
High Rate ◽  
Endoscopic Dilatation ◽  
Tertiary Referral Center ◽  
Esophageal Neoplasia ◽  
Esophageal Strictures

Background: Endoscopic resection of extensive esophageal neoplastic lesions is associated with a high rate of esophageal stricture. Most studies have focused on the risk factors for post-endoscopic esophageal stricture, but data on the therapeutic management of these strictures are scarce. Our aim is to describe the management of esophageal strictures following endoscopic resection for early esophageal neoplasia. Methods: We included all patients with an endoscopic resection for early esophageal neoplasia followed by endoscopic dilatation at a tertiary referral center. We recorded the demographic, endoscopic, and histological characteristics, and the outcomes of the treatment of the strictures. Results: Between January 2010 and December 2019, we performed 166 endoscopic mucosal resections and 261 endoscopic submucosal dissections for early esophageal neoplasia, and 34 (8.0%) patients developed an esophageal stricture requiring endoscopic treatment. The indication for endoscopic resection was Barrett’s neoplasia in 15/34 (44.1%) cases and squamous cell neoplasia (SCN) in 19/34 (55.9%) cases. The median [(interquartile range) (IQR)] number of endoscopic dilatations was 2.5 (2.0–4.0). Nine of 34 (26.5%) patients required only one dilatation, and 22/34 (65%) had complete dysphagia relief following three endoscopic treatment sessions. The median number of dilatations was significantly higher for SCN [3.0 (2–7); range 1–17; p = 0.02], and in the case of circumferential resection [4.0 (3.0–7.0); p = 0.03]. Endoscopic dilatation allowed a sustained dysphagia relief in 33/34 (97.0%) patients after a mean follow-up of 25.3 ± 22 months. Conclusion: Refractory post-endoscopic esophageal stricture is a rare event. After a median of 2.5 endoscopic dilatations, 97.0% of patients were permanently relieved of dysphagia. Circumferential endoscopic esophageal resections should be considered when indicated.

Endoscopic Treatment of Benign Esophageal Strictures with Removable or Biodegradable Stents

2017 ◽  
pp. 1119-1125
Author(s):  
Yvan Vandenplas ◽  
Bruno Hauser ◽  
Thierry Devreker ◽  
Daniel Urbain ◽  
Hendrik Reynaert
Keyword(s):  
Endoscopic Treatment ◽  
Esophageal Strictures ◽  
Biodegradable Stents

Endoscopic Treatment of Benign Esophageal Strictures with Removable or Biodegradable Stents

2011 ◽  
pp. 156-164
Author(s):  
Yvan Vandenplas ◽  
Bruno Hauser ◽  
Thierry Devreker ◽  
Daniel Urbain ◽  
Hendrik Reynaert ◽  
...  
Keyword(s):  
Endoscopic Treatment ◽  
Esophageal Strictures ◽  
Biodegradable Stents

scholarly journals Diagnostics and methods of endoscopic treatment of post-caustic esophageal strictures

2018 ◽  
Vol 0 (3) ◽  
Author(s):  
A. V. Klymenko ◽  
V. M. Klymenko ◽  
O. M. Kiosov ◽  
S. M. Gulevskiy ◽  
V. V. Kechedzhyiev
Keyword(s):  
Endoscopic Treatment ◽  
Esophageal Strictures

Efficacy of Intralesional Corticosteroid Injection in Endoscopic Treatment of Esophageal Strictures

2012 ◽  
Vol 22 (6) ◽  
pp. 518-522 ◽  
Author(s):  
Aitor Orive-Calzada ◽  
Antonio Bernal-Martinez ◽  
Maria Navajas-Laboa ◽  
Soraya Torres-Burgos ◽  
Maddi Aguirresarobe ◽  
...  
Keyword(s):  
Endoscopic Treatment ◽  
Corticosteroid Injection ◽  
Intralesional Corticosteroid ◽  
Esophageal Strictures

Endoscopic Treatment of Postradiation Strictures

1993 ◽  
Vol 79 (1) ◽  
pp. 34-36 ◽  
Author(s):  
Pasquale Spinelli ◽  
Franco Milani ◽  
Federicp Giuseppe Cerrai ◽  
Andrea Mancini ◽  
Domenico Corrado Ali ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Endoscopic Treatment ◽  
Esophageal Stricture ◽  
Radiation Treatment ◽  
Eating Habits ◽  
Rare Complication ◽  
Effective Procedure ◽  
Endoscopic Dilation ◽  
Esophageal Strictures ◽  
Dysphagic Patients

Background Esophageal stricture is a rare complication of radiotherapy: reports on its incidence and management are therefore anecdotal. Methods From January 1978 to September 1992, 44 patients presenting with an esophageal stricture related to a previous radiation treatment were endo-scopically dilated at the Endoscopy Division of the Istituto Nazionale Tumori of Milan. Results Esophageal recanalization was obtained in 95 % of the patients treated, and in 79 % of these normal eating habits were restored. No strict correlation was observed between radiation dose and severity of the stricture, or time elapsed between first treatment and endoscopic dilation. Conclusions In our experience, endoscopic dilation was a safe effective procedure and represented an effective palliative tool in dysphagic patients with esophageal strictures due to previous local radiotherapy.

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