Four-year experience in the treatment of upper gastrointestinal strictures with balloon dilatation.
(75/251)
One hundred and sixty-four cases of upper gastrointestinal tract stricture were treated by balloon dilatation in 4 years. A total of 682 procedures were performed. One hundred and forty cases (anastomosis stenosis 95, caustic stenosis 33 and other stenoses of the esophagus 12) were followed up with an effective rate of 90% (126/140) and a long-term effective rate of 71.4% (100/140). Fourteen cases (10%) failed, and 11 of them were due to tumor recurrence. The concept about the short-term and long-term effects, the criteria for evaluation of the results, the factors influencing the effectiveness, and the time suitable for dilatation are described. For the dilatation, indications are anastomosis stricture of the upper gastrointestinal tract, esophageal web and caustic stenosis of the esophagus. This method is also indicated for cicatricial stricture of the upper gastrointestinal tract of various causes. (+info)
Endoscopic repair of a complete post-radiation esophageal obstruction.
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We describe a 64-year-old man with squamous cell carcinoma of the esophagus who presented with an obstruction of the esophagus following radiation therapy and chemotherapy. Initial upper gastrointestinal barium swallow studies showed a complete stoppage of the barium column, not unlike that of a congenital esophageal atresia. Therapeutic endoscopy was performed using a two-endoscope, two-operator system that reestablished patency of the esophagus. Repeated endoscopy was then used to continue esophageal dilation with eventual placement of a permanent stent. A video and a comprehensive review of the literature regarding combined antegrade-retrograde dilation techniques used to date are also provided. (+info)
Gastrocoele: a complication of combined oesophageal and antral corrosive strictures.
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Self-dilatation of oesophageal strictures.
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A new technique for the management of upper and mid-oesophageal benign strictures is reported. A deflated oesophageal balloon catheter coated with steroid paste is passed by the patient through the stricture, the balloon is inflated and then withdrawn. This technique can be used for both strictures caused by tablet or corrosive damage that recur rapidly and where stricturing is the result of a chronic disease not amenable to medical or surgical treatments. Three patients in who this technique has been used with satisfactory patient tolerance and compliance and good relief of symptoms are reported. (+info)
Acquired oesophageal strictures in children: emphasis on the use of string-guided dilatations.
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INTRODUCTION: Acquired oesophageal strictures are common in children. Treatment is either surgical or conservative by dilatations. String-guided dilators (SGD) are not well popularised. This is a report of the paediatric surgery experience at Jordan University Hospital on a group of 38 children, with emphasis on the use of SGD. METHODS: Between January 1998 and January 2006, a total of 38 children (median age 3.2 years; range one month to ten years) with acquired oesophageal strictures were managed in the paediatric surgery unit. Main causes of strictures were corrosive strictures (18, 47.3 percent), post-oesophageal atresia repair (9, 23.6 percent) and post-hiatus hernia repair (4, 10.5 percent). SGD was used in 18 children, six following perforation and 12 classified as severe according to the established criteria. 14 were secondary to corrosive strictures. RESULTS: There were 801 dilatation sessions with an average of 20.1 +/- 17.3 dilatation sessions per patient. Corrosive strictures were more severe, and required more dilatations per patient. The mean dilatation was 34.2 +/- 16.6 for corrosive strictures vs. 10.4 +/- 8.2 for non-corrosive strictures (p-value is less than 0.0001). 32 (84.2 percent) were successfully dilatated. Two are currently still under treatment and four failed conservative treatment after dilatation for one year. Two underwent oesophageal replacement and two refused surgery but continued to receive dilatation at 4-6 week intervals. SGD was used on 18 patients, six following perforation episodes. Two (5.3 percent) complications resulted in oesophageal perforations. CONCLUSION: Tucker's dilators, with or without string, are safe, cost-effective and the use of string is a safeguard against perforations. (+info)