Esophageal balloon dilatation: experiences in 100 patients

Abstract Background and study aims Fluoroscopy-guided gastrointestinal procedures (FGPs) are increasingly common. However, the radiation exposure (RE) to patients undergoing FGPs is still unclear. We examined the actual RE of FGPs. Patients and methods This retrospective, single-center cohort study included consecutive FGPs, including endoscopic retrograde cholangiopancreatography (ERCP), interventional endoscopic ultrasound (EUS), enteral stenting, balloon-assisted enteroscopy, tube placement, endoscopic injection sclerotherapy (EIS), esophageal balloon dilatation and repositioning for sigmoid volvulus, from September 2012 to June 2019. We measured the air kerma (AK, mGy), dose area product (DAP, Gycm2), and fluoroscopy time (FT, min) for each procedure. Results In total, 3831 patients were enrolled. Overall, 2778 ERCPs were performed. The median AK, DAP, and FT were as follows: ERCP: 109 mGy, 13.3 Gycm2 and 10.0 min; self-expandable enteral stenting (SEMS): 62 mGy, 12.4 Gycm2 and 10.4 min; tube placement: 40 mGy, 13.8 Gycm2 and 11.1 min; balloon-assisted enteroscopy: 43 mGy, 22.4 Gycm2 and 18.2 min; EUS cyst drainage (EUS-CD): 96 mGy, 18.3 Gycm2 and 10.4 min; EIS: 36 mGy, 8.1 Gycm2 and 4.4 min; esophageal balloon dilatation: 9 mGy, 2.2 Gycm2 and 1.8 min; and repositioning for sigmoid volvulus: 7 mGy, 4.7 Gycm2 and 1.6 min. Conclusion This large series reporting actual RE doses of various FGPs could serve as a reference for future prospective studies.

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Esophageal balloon dilatation: A follow-up study in 74 patients

CardioVascular and Interventional Radiology ◽

10.1007/bf02575410 ◽

1989 ◽

Vol 12 (5) ◽

pp. 255-257 ◽

Cited By ~ 4

Author(s):

Joao Nóbrega

Keyword(s):

Balloon Dilatation ◽

Follow Up Study ◽

Esophageal Balloon

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Prospective evaluation of an indwelling esophageal balloon dilatation feeding tube for treatment of benign esophageal strictures in dogs and cats

Journal of Veterinary Internal Medicine ◽

10.1111/jvim.15071 ◽

2018 ◽

Vol 32 (2) ◽

pp. 693-700 ◽

Cited By ~ 4

Author(s):

Desmond K. Tan ◽

Chick Weisse ◽

Allyson Berent ◽

Kenneth E. Lamb

Keyword(s):

Balloon Dilatation ◽

Feeding Tube ◽

Prospective Evaluation ◽

Esophageal Strictures ◽

Esophageal Balloon

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DOZ047.53: Esophageal balloon dilatation for strictures developing after esophageal atresia surgery

Diseases of the Esophagus ◽

10.1093/dote/doz047.53 ◽

2019 ◽

Vol 32 (Supplement_1) ◽

Author(s):

C U Durakbasa ◽

B Aksu ◽

E Uzun ◽

D Ugurlu ◽

S Aydoner ◽

...

Keyword(s):

Esophageal Atresia ◽

Balloon Dilatation ◽

Colonic Anastomosis ◽

Median Number ◽

Esophageal Replacement ◽

Replacement Surgery ◽

Anastomosis Site ◽

Esophageal Anastomosis ◽

Esophageal Balloon ◽

Target Pressure

Abstract Aim The aim of this study is to evaluate the results of esophageal balloon dilatation (BD) for strictures after esophageal atresia (EA) surgery. Methods Flexible endoscopic BD was done under fluoroscopic and manometric control. The balloon placed in the stricture was inflated by contrast. The target pressure and the diameter were decided in compliance with the manufacturer's directions as well as fluoroscopic guidance. The balloon was kept inflated for 3 minutes. Prospectively collected data over 10 years were retrospectively evaluated. Cure was defined as no need for dilatation during the last 12 months. Results A total of 79 patients with variable diagnoses underwent 481 BD. Forty (51%) had strictures which developed after EA surgery. They underwent 175 (36%) BD (P < 0.05). There were 21 males and 19 females. The atresia was distal fistula type in 31 (77.5%) patients and isolated EA in nine (22.5%). The BD was done for primary esophago-esophageal anastomosis site in 37 patients. The remaining three patients with long gap EA had undergone previous replacement surgery and the BD was done for the proximal esophago-colonic anastomosis. The median age at the time of the first BD was 14 months with 17 (43%) patients below the age of 1 year. The maximal inflation diameter varied between 5–20 mm. Esophageal BD catheters were used in all except two occasions where 5 mm ureteral balloons were used. The median number of BD was four (n = 1–15). Thirty-four (85%) patients underwent more than one BD. A transmural perforation was encountered in one occasion (0.6%) and the patient eventually underwent esophageal replacement surgery with an uneventful outcome. There was no mortality. Fundoplication was done in nine patients. Thirty-three patients (82.5%) were regarded as ‘cure’. Conclusion Esophageal BD is employed for strictures caused by a variety of reasons. Patients with EA comprise a substantial number of cases needing BD and have strictures less resistant to dilatation. The technique employed in this study is advantageous because it enables direct endoscopic visualization of the stricture and both gradual and controlled increase of the dilatation pressure. BD is safe and efficient yet there is a risk of esophageal perforation as in the other dilatation techniques.

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