Occurrence of and risk factors for complications after endoscopic dilation in eosinophilic esophagitis.
Gastrointest Endosc
; 73(1): 15-21, 2011 Jan.
Article
em En
| MEDLINE
| ID: mdl-21067739
ABSTRACT
BACKGROUND:
Several small series have suggested an increased risk of complications associated with esophageal dilation in patients with eosinophilic esophagitis (EoE).OBJECTIVE:
To quantitate the risk and identify risk factors for esophageal complications in dilation in EoE patients.DESIGN:
Retrospective, uncontrolled, single-center study.SETTING:
Tertiary referral hospital. PATIENTS A total of 161 EoE patients (mean ± standard deviation age 44.3 ± 15.3 years, 112 men, 49 women, 150 white patients, 10 unknown, 1 Asian).INTERVENTIONS:
Through-the-scope balloon or Savary dilation of EoE. MAIN OUTCOME MEASUREMENTS The rate of complications defined as deep mucosal tear, major bleeding, or perforation, and determination of risk factors for complications.RESULTS:
A total of 293 dilations were performed in 161 patients. Complications reported were deep mucosal tear in 9.2% (n = 27), major bleeding in 0.3% (n = 1), and immediate perforation in 1.0% (n = 3). All patients with perforations were successfully treated medically without surgery (mean ± standard deviation hospital stay 5.3 ± 3.2 days). Factors associated with an increased risk of complications were luminal narrowing in the upper (odds ratio [OR], 5.62; 95% CI, 2.07-15.26; P < .001) and middle third of the esophagus (OR, 4.93; 95% CI, 1.64-14.83; P < .005) compared with lower third, luminal stricture unable to be traversed with a standard upper endoscope (OR, 2.48; 95% CI, 1.06-5.83; P = .037), and use of Savary dilator (OR, 2.63; 95% CI, 1.18-5.83; P = .018).LIMITATIONS:
Retrospective design, uncontrolled study.CONCLUSIONS:
Deep mucosal tears are common after dilation (9%), but the risk of immediate transluminal perforation with EoE is approximately 1%. The risk of severe complications is increased in patients with more proximal stricture and strictures that initially prevent endoscope passage.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Cateterismo
/
Esofagoscopia
/
Lacerações
/
Perfuração Esofágica
/
Estenose Esofágica
/
Esofagite Eosinofílica
/
Hemorragia Gastrointestinal
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Gastrointest Endosc
Ano de publicação:
2011
Tipo de documento:
Article
País de afiliação:
Estados Unidos