Endoscopy 2020; 52(S 01): S34
DOI: 10.1055/s-0040-1704110
ESGE Days 2020 oral presentations
Saturday, April 25, 2020 11:00 – 13:00 Advances in endoluminal endoscopy Liffey Meeting Room 2
© Georg Thieme Verlag KG Stuttgart · New York

BOUGIECAP DILATATION DEVICE: NOVEL ENDOSCOPIC METHOD FOR TREATMENT OF OESOPHAGEAL STRICTURES-RESULTS FROM A MULTICENTRE STUDY

P Duarte
1   University Hospital Southampton NHS Foundation Trust, Southampton Interventional Endoscopy Unit, Southampton, UK
,
W Benjamin
2   Ulm University Hospital, Ulm, Germany
,
P Patel
1   University Hospital Southampton NHS Foundation Trust, Southampton Interventional Endoscopy Unit, Southampton, UK
,
P Boger
1   University Hospital Southampton NHS Foundation Trust, Southampton Interventional Endoscopy Unit, Southampton, UK
,
S Schmidbaur
2   Ulm University Hospital, Ulm, Germany
,
D Albers
3   Elisabethkrankenhaus Hospital, Essen, Germany
,
B Schumacher
3   Elisabethkrankenhaus Hospital, Essen, Germany
,
A Meining
2   Ulm University Hospital, Ulm, Germany
,
I Rahman
1   University Hospital Southampton NHS Foundation Trust, Southampton Interventional Endoscopy Unit, Southampton, UK
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

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Aims A novel dilatation device, BougieCap (Ovesco, Germany), allows both tactile and optic feedback of the dilatation procedure without the need for fluoroscopy. The aim of this study was to assess the safety and efficacy of this device in a prospective cohort of patients.

Methods Patients with benign oesophageal strictures and symptoms of dysphagia were recruited from 3 centres in the UK and Germany for planned dilatation with the BougieCap. The device is a single use transparent conical cap which is fixed to the tip of the endoscope. Once in place, the endoscope is inserted and positioned in front of the stricture and by pushing forward and rotating with the endoscope, enables the conical cap to dilate the mucosa. The primary outcome measure was technical success of dilatation. Secondary outcome measures were improvement in symptoms of dysphagia, assessed by the Dysphagia Handicap index (DHI) before and 14 day after the procedure, and adverse events.

Results 104 patients with benign oesophageal strictures underwent BougieCap dilatation between February 2018 to September 2019. Aetiology of strictures were peptic 63%, radiation 15%, anastomotic 7%, caustic 6%, EoE 5%, post-ESD/EMR 4%. Mean diameter of strictures was 5 mm (±2.3). Bougienage was successful in 97%. In 3 cases, with a narrow long stricture, bougienage failed because of high resistance at the site of the stricture causing buckling of the endoscope in the pharynx. Symptoms of dysphagia improved after bougienage (53 points Day 0 v 21 points day 14, p< 0.01). No severe adverse events were reported.

Conclusions Endoscopic treatment of benign strictures using the BougieCap is highly successful and safe. It enables direct visual and tactile control of the bougienage procedure with control of mucosal damage within the strictured area. This might help to adapt treatment more precisely to the stricture. Symptoms of dysphagia are improved in short-term follow-up.