Endoscopy 2019; 51(09): 866-870
DOI: 10.1055/a-0959-1535
Innovations and brief communications
© Georg Thieme Verlag KG Stuttgart · New York

The BougieCap – a new method for endoscopic treatment of complex benign esophageal stenosis: results from a multicenter study

Benjamin Walter
1  InExEn, Klinik für Innere Medizin I, Universitätsklinikum Ulm, Ulm, Germany
,
Simone Schmidbaur
1  InExEn, Klinik für Innere Medizin I, Universitätsklinikum Ulm, Ulm, Germany
,
Imdadur Rahman
2  University Hospital of Southampton NHS Foundation Trust, Southampton, United Kingdom
,
David Albers
3  Klinik für Innere Medizin und Gastroenterologie, Elisabethkrankenhaus, Essen, Germany
,
Brigitte Schumacher
3  Klinik für Innere Medizin und Gastroenterologie, Elisabethkrankenhaus, Essen, Germany
,
Alexander Meining
1  InExEn, Klinik für Innere Medizin I, Universitätsklinikum Ulm, Ulm, Germany
› Author Affiliations
TRIAL REGISTRATION: Multicenter, prospective trial NCT03349021 at clinicaltrials.gov
Further Information

Publication History

submitted 06 December 2018

accepted after revision 16 May 2019

Publication Date:
23 July 2019 (online)

Abstract

Background A major limitation of current treatment strategies for nonmalignant upper gastrointestinal stenoses is the lack of either optical or haptic feedback during dilation. Wire guidance and fluoroscopy is often necessary to control the position.

Methods A novel device for endoscopic dilation, the BougieCap (Ovesco Endoscopy AG, Tübingen, Germany) was evaluated in a prospective multicenter trial. Primary outcome was successful dilation of stenosis and secondary outcome was alteration in dysphagia symptoms in short-term follow-up. 

Results 50 patients with benign esophageal strictures were included. Endoscopic bougienage was successful in 96 %. Bougienage failed in two cases because of high resistance. Symptoms of dysphagia decreased significantly after bougienage (59.0 points at Day 0 vs. 28.6 points at Day 14; P < 0.001). Adverse events were loss of BougieCap into the stomach in two cases; no severe adverse events were reported.

Conclusions Endoscopic treatment of benign stenoses using the BougieCap enabled direct visual control of the bougienage procedure. This might help to adapt treatment more precisely to the stricture. Symptoms of dysphagia were improved in short-term follow-up. Additional wire guidance may be used for selected cases (e. g. narrow lumen, pediatric scope).