Study of acquired oesophageal strictures

Authors

  • Nandakishor Jaiswal Department of Surgery, Government Medical College and Hospital, Nagpur, Maharashtra, India
  • Kirti Jaiswal Department of Pathology, Government Medical College and Hospital, Nagpur, Maharashtra, India
  • Amit V. Deshpande Department of Surgery, Government Medical College and Hospital, Nagpur, Maharashtra, India

DOI:

https://doi.org/10.18203/2349-2902.isj20182218

Keywords:

Carcinoma oesophagus, Oesophageal stricture

Abstract

Background: We profiled the patients of acquired oesophageal strictures coming to our hospital in terms of causes, clinical presentation, efficacy of investigations and treatment modalities.

Methods: In this two-year observational study, all patients presenting with complaint of difficulty in swallowing were enrolled and subjected to detailed history taking, examination, barium swallow study and other investigations. The patients were managed with surgical and/or non-surgical approaches, as indicated.

Results: Out of total 46 eligible patients, 34 presented with malignant strictures while 12 presented with benign ones. Dysphagia was the commonest symptom in patients with malignant (31, 91.17%) as well as benign strictures (12, 100%). Shouldering with hold up of barium (19, 55.88%) was the most common finding noted in malignant strictures, while those with benign stricture had smooth tapering (7, 58.33%) as the commonest finding. On flexible endoscopy, the level of growth corroborated with the barium swallow findings in all 34 patients with malignant strictures and the lower one third (16, 47.05%) was observed to be the most common site of affection. Majority (21, 58.8%) of patients were having squamous cell carcinoma, with adenocarcinoma dominating in lower one third lesions (13 out of 16, 81.25%). No cases of adenocarcinoma were noted in middle and upper one third lesions.

Conclusions: Majority of patients with malignant strictures were having squamous cell carcinoma, with adenocarcinoma dominating in lower one third lesions. Surgical resection led to relief from dysphagia in all the 6 cases of oesophagectomy with oesophagogastric anastomosis in malignant stricture cases with excellent long term survival and symptomatic relief

References

Gupta NM, Jindal R, Gupta R. Comparison of the clinical profile and outcome for squamous cell carcinoma and adenocarcinoma of distal oesophagus and cardia in India. Surg Tod, 2001;31:401-4.

Richter JE, Gastroesophageal reflux disease in the older patients: presentation, treatment and complications. Am J Gastroenterol. 2000;9:368-73.

Marvin MK, Peterson A, Brown J, mark B. Ingestion of corrosive substance by adults: A ten year experience. Ann Surg. 1978;188:675-8.

Bonavina L, Demeester TR, McChesney L, Schwizer W, Albertucci M, Bailey RT. Drug induced oesophageal stricture. Ann Surg. 1987;206:173-83.

Pie-Yen Young. Surgical therapy for carcinoma oesophagus. Annal Thor Surg. 1983;35:143-57.

Sharif Jan, Mannel A. Role of Bariums studies in diagnosis of Carcinoma Oesophagus. Br Jour Surg. 1991;78:36-40.

Fionna JG, Anderson J. Diagnosis and staging of gastro-oesophageal malignancies. Scottish Audit of gastric and oesophageal cancer. Report:1997-2000.

Ott DJ, Chen YM, Wu WC, Gelfand DW. Endoscopic sensitivity in the detection of esphageal strictures. J Clin Gastroenterol. 1985;7:121-5.

Creteur V, Thoeni RF, Federle MP. The role of single- and double contrast radiography in the diagnosis of reflux esophagitis. Radiol, 1983;147:71-5.

Pia Luedtke, Levine MS, Rubesin SE. Radiological diagnosis of benign esophageal strictures: A pattern approach. Radiograp. 2003;23:897-909.

Byrne JP, Mathers JM. Site distribution of oesophagogastric cancer. J Clini athol. 2002;55:191-4.

Von FM, Ackermann C, Tondelli P. Surgery in oesopahgeal carcinoma-risks and results. Schweiz Med Wonchwnschi. 1990;120:515-7.

Maher M, Ali M. Transhiatal oesophagectomy for carcinoma oesophagus- early experience. J Pak Med Assoc. 1991;41:129-31.

Downloads

Published

2018-05-24

Issue

Section

Original Research Articles