THE BOUGIE-CAP: A NEW METHOD FOR TREATMENT OF OESOPHAGEAL STRICTURES

Aims:

Current treatment strategies for therapy of non-malignant stenoses of the upper GI tract comprise polyvinyl Savary-Gilliard dilators or dilatation ballons. A major problem of these techniques is the lack of optical and haptic feedback of the dilation. Furthermore, wire guidance and X-ray imaging is often necessary to control the position.

Methods:

A new tool (BougieCap, Ovesco, Germany) designed for endoscopic treatment of benign stenosis of the upper GI tract has been evaluated in an ongoing clinical trial. Technical success, regarding sufficient stenosis treatment is defined as primary outcome. Secondary endpoint is defined as alteration in QoL after treatment regarding dysphagia, assessed by dysphagia questionnaire before and 14 days after treatment.

Results:

We report on 8 patients who have been treated with the BougieCap in our hospital. 10 mm caps for pediatric endoscopes and 12, 14, 16 mm caps for standard gastroscopes were used. Origin of the stenoses were peptic, radiation induced and post-surgery. Age of patients ranged from 31 to 95 years. In all patients bougienage by the BougieCap was feasible with no major side effects. Passage with the endoscope to the duodenum after bougienage was possible in all cases. Symptoms of dysphagia were significantly improved in all patients.

Conclusions:

As an interim result of an ongoing study we conclude that endoscopic treatment of benign stenosis of the upper GI tract using the newly designed BougieCaps offers a direct optical control of the bougienage procedure (thereby potentially reducing severe side effects) and is associated with a relevant improvement of QoL for treated patients.