Self-Dilation as a Treatment for Resistant, Benign Esophageal Strictures

Goals and Background Simple benign strictures may be relieved with one to three dilation sessions. Resistant benign strictures are anatomically complex and resistant to therapy. We sought to determine the efficacy and safety of esophageal self-dilation with bougie dilators in the largest series to d...

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Bibliographic Details
Published in:Digestive diseases and sciences 2013-11, Vol.58 (11), p.3218-3223
Main Authors: Dzeletovic, Ivana, Fleischer, David E., Crowell, Michael D., Pannala, Rahul, Harris, Lucinda A., Ramirez, Francisco C., Burdick, George E., Rentz, Lauri A., Spratley, Robert V., Helling, Susan D., Alexander, Jeffrey A.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Biochemistry
Cancer
Care and treatment
Deglutition disorders
Development and progression
Dilatation - instrumentation
Dilatation - methods
Esophageal Stenosis - therapy
Female
Gastroenterology
Hepatology
Humans
Male
Medicine
Medicine & Public Health
Middle Aged
Oncology
Original Article
Photochemotherapy
Pneumoviridae
Radiotherapy
Transplant Surgery
Young Adult
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Summary:Goals and Background Simple benign strictures may be relieved with one to three dilation sessions. Resistant benign strictures are anatomically complex and resistant to therapy. We sought to determine the efficacy and safety of esophageal self-dilation with bougie dilators in the largest series to date. Study A retrospective chart review was performed to identify patients who underwent esophageal self-dilation at two tertiary referral centers (Mayo Clinic, Scottsdale, Arizona and Mayo Clinic Rochester, Minnesota) between January 1, 2003 and June 30, 2012. Demographic details and clinical information regarding relief of dysphagia, complications, and frequency of endoscopic and self-dilation were abstracted. Results Of the 32 patients who began self-dilation for nonmalignant strictures, 30 [22 men; median (range) age, 62 years (22–86 years)] were included in the study. Median (range) follow-up was 37 months (14–281 months). Stricture etiology included radiation therapy ( n  = 8), anastomotic stricture ( n  = 9), eosinophilic esophagitis ( n  = 4), caustic ingestion ( n  = 3), photodynamic therapy ( n  = 2), granulation tissue ( n  = 2), peptic stricture ( n  = 1) and one patient had radiation therapy and peptic stricture. The average number (range) of physician performed dilations before self-dilation was 12 (4–55). Esophageal self-dilation was successful in treating 90 % of patients. Dysphagia score (2 vs. 1; P  
ISSN:0163-2116
1573-2568
DOI:10.1007/s10620-013-2822-7