Management of benign oesophageal strictures: our experience at tertiary care centre

Anagha S. Varudkar; Santoshkumar N. Deshmukh; Dyanesh D. Vitekar

doi:10.18203/2349-2902.isj20170859

Authors

Anagha S. Varudkar Department of General Surgery, Dr. Vaishampayan Memorial Government Medical College, Solapur, Maharashtra, India
Santoshkumar N. Deshmukh Department of General Surgery, Dr. Vaishampayan Memorial Government Medical College, Solapur, Maharashtra, India
Dyanesh D. Vitekar Department of General Surgery, Dr. Vaishampayan Memorial Government Medical College, Solapur, Maharashtra, India

DOI:

https://doi.org/10.18203/2349-2902.isj20170859

Keywords:

Benign stricture, Dilatation, Etiology, Endoscope, Oesophagus

Abstract

Background: Oesophageal stricture is a common problem in general surgical practice. It can be benign or malignant, simple or complex. Benign oesophageal strictures include peptic, corrosive, post-surgical anastomotic strictures, post radiotherapy and drug induced strictures. The aetiology of this condition varies in developed and developing countries. Aim of present study was to determine the aetiology of benign oesophageal stricture, to evaluate the role of endoscopic dilatation of stricture and final outcome in these patients in our region.

Methods: This prospective descriptive study was conducted in department of surgery at a tertiary care teaching hospital at Aurangabad from December 2009 to November 2013. All the patients, regardless of age and gender, admitted with diagnosis of benign oesophageal stricture were included in the study. Depending upon the type of stricture treatment was carried out. Postoperatively patients were followed up for detection of possible complications and their treatment.

Results: Total 50 patients of oesophageal stricture were studied. Mean age was 33.65 years with male to female ratio 2.8:1. Ingestion of corrosive substance was the commonest etiology noted followed by peptic strictures.

Conclusions: Corrosive ingestion was the commonest cause of benign oesophageal stricture in our region followed by peptic strictures. Endoscopic dilatation is safe and effective in treating benign oesophageal strictures.

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References

Hyoung JK, Hoon JS, Young S. Benign strictures of the esophagus and gastric outlet: Interventional Management. Korean J Radiol. 2010;11:497-506.

Lew RJ, Kochman ML. A review of endoscopic methods of esophageal dilation. J Clin Gastroenterol 2002;35:117-26.

Lima JC, Ramires RP, Zamin I, Cassal AP, Marroni CA, Mattos AA. Endoscopic dilation of benign esophageal strictures: report on 1043 procedures. Am J Gastroenterol. 1999;94:1497-501.

Kim JH, Song HY, Kim HC, Shin JH, Kim KR, Park SW, et al. Corrosive esophageal strictures: long-term effectiveness of balloon dilation in 117 patients. J Vasc Interv Radiol. 2008;19:736-41.

Siersema PD. Treatment options for esophageal strictures. Nat Clin Pract Gastroenterol Hepatol. 2008;5:142-52.

Choi GB, Shin JH, Song HY, Lee YS, Cho YK, Bae JI, et al. Fluoroscopically guided balloon dilation for patients with esophageal stricture after radiation treatment. J Vasc Interv Radiol. 2005;16:1705-10.

Kim JH, Song HY, Park SW, Yoon CJ, Shin JH, Yook JH, et al. Early symptomatic strictures after gastric surgery: palliation with balloon dilation and stent placement. J Vasc Interv Radiol. 2008;19:565-70.

Patterson DJ, Graham DY, Smith JL. Natural history of benign esophageal stricture treated by dilation. Gastroenterology. 1983;89:346-50.

Williamson RCN. The management of peptic esophageal stricture. Br J Surg. 1975;62:448-54.

Broor SL, Kumar A, Chari ST, et al. Corrosive esophageal strictures following acid ingestion: clinical profile results of endoscopic dilatation. J Gastroenterol Hepatol. 1989;4:56-61.

Earlam R, Cunha JR. Benign esophageal strictures: historical and technical aspects of dilation. Br J Surg. 1981;68:829-36.

Lahoti D, Broor SL. Corrosive injury to upper gastrointestinal tract. Indian J Gastroenterol. 1993;12:135-41.

Zargar SA, Kocher R, Nagi B, Mehta S, Mehta SK. Ingestion of corrosive acids. Spectrum of injury in upper gastrointestinal tract and natural history. Gastroenterolgy. 1989;97:702-7.

Qureshi S, Ghazanfar S, Leghari A, Tariq F. Benign esophageal strictures: Behaviour, pattern and response to dilatation. J Pak Med Assoc. 2010;60(8):656-60.

Naharci M, Tuzun A, Erdil A, Ates Y, Bagci S, Yamanel L, et al. Effectiveness of bougie dilation for the management of corrosive esophageal strictures. Acta Gastroenterol Belg. 2006;69:372-6.

Hernandez LV, Jacobson JW, Harris MS. Comparison among the perforation rates of Maloney, balloon, and savary dilation of esophageal strictures. Gastrointest Endosc. 2000;51:460-2.

Karnak I, Tanyel FC, Büyükpamukçu N, Hiçsönmez A. Esophageal perforations encountered during the dilation of caustic esophageal strictures. J Cardiovasc Surg. 1998;39:373-7.

Silvis SE, Nebel O, Rogers G. Endoscopic complications: results of the 1974 American society of gastrointestinal endoscopy survey. JAMA. 1976;235:928-30.

Mandelstam P, Sugawa C, Silvis SE. Complications associated with Esophago-gastroduodenoscopy and with esophagaeal dilation. Gastrointest Endosc. 1976;23:16-29.

Shaffer HA, Valenzvela G, Mittal RK. Esophageal perforation a reassessment of the literature for choosing medical or surgical therapy. Arch Intern Med. 1992;152:757-61.

Andreollo NA, Lopes LR, Inogutti R, Brandalise NA, Leonardi LS. Conservative management of benign esophageal strictures using dilation. Analysis of 500 cases. Rev Assoc Med Bras. 2001;47:236-43.