Self-bougienage: long-term relief of corrosive esophageal strictures.
Article
in En
| IMSEAR
| ID: sea-64543
ABSTRACT
BACKGROUND:
Corrosive esophageal strictures require dilatation at frequent intervals.OBJECTIVE:
To determine the efficacy of self-dilatation in treatment of corrosive esophageal strictures.METHODS:
Retrospective analysis of data from 51 patients with corrosive esophageal strictures seen in a surgical unit. Eighteen patients underwent per-oral antegrade dilatation of stricture using gum elastic bougies (Group I); 15 patients underwent retrograde dilatation with endless string using an India rubber dilator devised at the authors' institution, followed by per-oral antegrade dilatation (Group II); 15 patients underwent retrograde dilatation followed by antegrade dilatation with endless string through esophagostomy (Group III). In three patients with stricture of the entire esophagus, endless string could not be passed; they were subjected to esophagocoloplasty. All patients were taught self-dilatation with gum elastic bougies as the final step, and were put on a progressive, domiciliary, self-dilatation program. Quarterly follow up was done for one year, to ascertain whether self-bougienage was being performed properly.RESULTS:
All patients responded well to treatment, with significant relief of dysphagia and improvement in health and barium study findings. Six patients developed mediastinitis (3, 2 and 1 in Groups I, II and III, respectively) during initial dilatation; all improved with conservative management. Only one patient who failed to carry out self-bougienage had to be readmitted and retrained in the procedure, after which he remained asymptomatic.CONCLUSIONS:
Patients with corrosive esophageal strictures can be treated with a long-term self-bougienage program, which avoids the need for frequent hospital admissions for esophageal dilatation.
Full text:
1
Index:
IMSEAR
Main subject:
Self Care
/
Burns, Chemical
/
Female
/
Humans
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Male
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Esophagostomy
/
Retrospective Studies
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Adolescent
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Treatment Outcome
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Adult
Type of study:
Observational_studies
Language:
En
Year:
2001
Type:
Article