Endoscopic dilatation of benign organic esophageal strictures

Aims Endoscopic dilatation is the treatment of choice for benign organic esophageal strictures (BOS), with excellent efficacy and a low complication rate. The aim of our work is to evaluate the efficacy of the endoscopic dilatation technique in the management of organic esophageal strictures.

Methods This is a retrospective study in which 31 patients were included from March 2018 to May 2023 in the EFD-HGE department, presenting with esophageal strictures, having benefited from 101 endoscopic dilatations of the esophagus by Savary-Gillard candles and hydrostatic balloons. Patients were excluded from the study in case of: Achalasia and SBO in children.

Results The mean age of our patients was 38.4 years, predominantly female. All patients in our series presented with dysphagia. Esophageal fibroscopy showed esophageal stenosis in the upper third in 18 patients (60%), in the middle third in 5 (16.6%), in the lower third in 3 (10%) and in the middle third in 5 (16.6%). It was impassable in all patients. In our series, the two main etiologies of SBO are caustic stenosis and Plummer Vincent syndrome. 23 patients (76.6%) showed complete remission after less than 5 sessions, with a dysphagia score of 0 to 1. Five patients (16.6%) had refractory stenosis, and 3 cases (10%) of failure were noted, linked to failure to clear the stenosis in 2 patients and a complication in another. A single perforation complication was reported in a patient with a staged caustic stenosis dilated by balloon, representing 3.2% of patients but only 0.9% of total dilatation sessions.

Conclusions Esophageal dilatation is a safe and effective treatment for benign esophageal strictures, and complications are rare when the procedure is carried out correctly.

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Artikel online veröffentlicht:
27. März 2025