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Endoscopic dilation with bougies versus balloons in caustic esophageal strictures: 17-year experience from a tertiary care center.
Singh, Anupam Kumar; Reddy, Yalaka Rami; Jena, Anuraag; Appasani, Sreekanth; Gupta, Pankaj; Sinha, Saroj Kant; Kochhar, Rakesh.
Afiliação
  • Singh AK; Department of Gastroenterology, Nehru Hospital, Postgraduate Institute of Medical Education and Research (PGIMER), Sector-12, Chandigarh, 160012, India.
  • Reddy YR; Department of Gastroenterology, STAR Hospital, Nanakramguda, Hyderabad, India.
  • Jena A; Department of Gastroenterology, Topiwala National Medical College & BYL Nair Hospital, Mumbai, India.
  • Appasani S; Department of Medical Gastroenterology, KIMS Hospital, Secunderabad, India.
  • Gupta P; Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
  • Sinha SK; Department of Gastroenterology, Nehru Hospital, Postgraduate Institute of Medical Education and Research (PGIMER), Sector-12, Chandigarh, 160012, India.
  • Kochhar R; Department of Gastroenterology, Nehru Hospital, Postgraduate Institute of Medical Education and Research (PGIMER), Sector-12, Chandigarh, 160012, India. dr_kochhar@hotmail.com.
Surg Endosc ; 37(11): 8236-8244, 2023 11.
Article em En | MEDLINE | ID: mdl-37653157
ABSTRACT

INTRODUCTION:

Endoscopic dilation is the preferred management strategy for caustic esophageal strictures (CES). However, the differences in outcome for different dilators are not clear. We compared the outcome of CES using bougie and balloon dilators.

METHODS:

Between January 2000 and December 2016, the following data of all the patients with CES were collected demographic parameters, substance ingestion, number of strictures, number of dilations required to achieve ≥ 14 mm dilation, post-dilation recurrence, and total dilations. Patients were divided into two groups for the type of dilator, i.e., bougie or balloon. The two groups were compared for baseline parameter, technical success, short- and long-term clinical success, refractory strictures, recurrence rates, and major complications.

RESULTS:

Of the 189 patients (mean age 32.17 ± 12.12 years) studied, 119 (62.9%) were males. 122 (64.5%) patients underwent bougie dilation and 67 (35.5%) received balloon dilation. Technical success (90.1% vs. 68.7%, p < 0.001), short-term clinical success (65.6% vs. 46.3%, p value 0.01), and long-term clinical success (86.9% vs. 64.2%, p < 0.01) were higher for bougie dilators compared to balloon dilators. Twenty-four (12.7%) patients developed adverse events which were similar for two groups. On multivariate analysis, use of bougie dilators (aOR 4.868, 95% CI 1.027-23.079), short-term clinical success (aOR 5.785, 95% CI 1.203-27.825), and refractory strictures (aOR 0.151, 95% CI 0.033-0.690) were independent predictors of long-term clinical success.

CONCLUSION:

Use of bougie dilators is associated with better clinical success in patients with CES compared to balloon dilators with similar rates of adverse events.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Cáusticos / Estenose Esofágica Tipo de estudo: Prognostic_studies Limite: Adult / Female / Humans / Male Idioma: En Revista: Surg Endosc Assunto da revista: DIAGNOSTICO POR IMAGEM / GASTROENTEROLOGIA Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Índia

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Cáusticos / Estenose Esofágica Tipo de estudo: Prognostic_studies Limite: Adult / Female / Humans / Male Idioma: En Revista: Surg Endosc Assunto da revista: DIAGNOSTICO POR IMAGEM / GASTROENTEROLOGIA Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Índia