Endoscopy 2019; 51(04): S236-S237
DOI: 10.1055/s-0039-1681880
ESGE Days 2019 ePosters
Friday, April 5, 2019 09:00 – 17:00: Esophagus ePosters
Georg Thieme Verlag KG Stuttgart · New York

FACTORS INFLUENCING THE LONG TERM OUTCOME OF CAUSTIC ESOPHAGEAL STRICTURE DILATATION USING SAVARY DILATORS

M Manzoor Haque
1   Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan
,
Z Majid
1   Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan
,
N Hassan Luck
1   Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan
,
N Mehmood
1   Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan
,
G Bux Soomro
1   Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

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Aims:

Less is known in the literature about the management and long-term outcome of Caustic esophageal stricture (CES). It is reported from developing countries particularly in pediatric and adolescent age group. The study is aimed to assess the long-term outcome of CES dilatation using Savary Gilliard dilator and also the factors associated with better outcome.

Methods:

We retrospectively reviewed the medical record of patients who underwent CES dilatation using Savary Gilliard dilatators from July 2008 to July 2018. Rule of three was used for the esophageal stricture dilatation. Data is expressed in frequency, percentage, mean and standard deviation. Mann-whitney U test is used to determine the factors associated with better outcome.

Results:

Twenty one patients were included in study, mean age of patients was 21 ± 19.4. Out of twenty one 12 (57.1%) were males. More than half of them were in pediatric age group 11 (52.4%). Acid ingestion was seen in 14 (66.7%) while 7 (33.3%) patient had alkali ingestion. Accidental corrosive intake was found in 16 (76.2%), however 5 (23.8%) patients had taken it with suicidal intent. Most of patient had zargar's class IIA 12 (57.1%) injury. Mean length of stricture was 7.3 ± 4.5 cm and range of number of dilatation required was 4 to 59 sessions. Over all pediatric patients required less number of session as compare to adults (p value = 0.008). Four patients had complex stricture. Complex stricture (p = 0.018) and stricture longer then 10 cm (p = 0.028) required more sessions of dilatations. Complete resolution of stricture was noted in 18 (85.7%) patients while 3 (14.5%) patients with complex stricture still require dilatations. Six patients had associated pyloric stenosis, managed via CRE balloon dilatation and while two required gastrojujenostomy. One patients developed minor perforation during the procedure.

Conclusions:

CES can be successfully managed via savary dilatations, long and complicated stricture required more sessions of dilatations while pediatric patients are better responders to treatment.