Endoscopy 2018; 50(04): S33
DOI: 10.1055/s-0038-1637125
ESGE Days 2018 oral presentations
20.04.2018 – Digestive tract strictures: dilation, stenting
Georg Thieme Verlag KG Stuttgart · New York

EFFECTIVENESS OF REPEATED DILATIONS IN THE MANAGEMENT OF ESOPHAGEAL BENIGN STRICTURES

A Benezech
1   Assistance Publique – Hôpitaux de Marseille, CHU Nord, Service de Gastroentérologie, Marseille, France
,
A Debourdeau
1   Assistance Publique – Hôpitaux de Marseille, CHU Nord, Service de Gastroentérologie, Marseille, France
,
JM Gonzalez
1   Assistance Publique – Hôpitaux de Marseille, CHU Nord, Service de Gastroentérologie, Marseille, France
,
M Barthet
1   Assistance Publique – Hôpitaux de Marseille, CHU Nord, Service de Gastroentérologie, Marseille, France
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2018 (online)

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Aims:

Refractory esophageal benign strictures (REBS) are defined as the impossibility to reach or maintain a diameter of 14 mm after 5 sessions of endoscopic dilation (ED). Their management remains challenging. The aim of this study was to define the efficacy of long-term and repeated ED in the management of REBS.

Methods:

This monocentric retrospective study involved patients who underwent ED between 2002 and 2017 for REBS. The primary endpoint was the efficacy of sustained and recurrent ED, defined as the absence of further ED within 3 months of the last procedure or an interval between the 2 last ED greater than 3 months. A failure was considered in case of death, need for surgery, permanent enteral feeding tube or the need for more frequent dilations. The secondary endpoints were to document the characteristics of endoscopic procedures, the decreasing of the number of ED per trimester, and to elucidate potential predictive factors for success of ED.

Results:

39 patients were included. A clinical success of repeated ED was achieved in 27 patients (69.2%). 12 patients (30.8%) experienced failure (7 required frequent dilatations, 2 underwent surgery, 2 with enteral feeding tube, 1 patient died consecutively to inhalation pneumonia). A mean of 9.8 ± 4 ED sessions were performed per patient, with a mean treatment duration of 22.6 ± 20.1 months. The number of dilations per trimester gradually decreased over time. No significant predictive factor of success was found, especially regarding etiology of stricture. Nevertheless, a greater number of dilations during the first trimester could promote the success of the management (3.2 ± 2.2 vs. 2.2 ± 0.8, p = 0,056).

Conclusions:

Repeated and maintained ED are effective in the management of REBS. A prolonged management up to 2 years, and the initial rhythm of endoscopic procedures may favor the final success. A systematic schedule for ED would improve the efficacy of this management.