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Outcome of dilatation and predictors of failed dilatation in patients with acid-induced corrosive esophageal strictures

机译：酸诱导腐蚀性食管狭窄患者扩张失败的扩张和预测因子的结果

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摘要

Outcome of endoscopic dilatation in acid-induced corrosive esophageal stricture is less known. This study aims to determine the outcome of dilatation and predictors of failed dilatation in patients with acid-induced corrosive esophageal stricture. Patients diagnosed of corrosive esophageal strictures were included. Endoscopic dilatation with graded Savary-Gilliard dilator was performed as the first line treatment. Outcome of dilatation was considered favorable when patients were able to swallow solid without intervention at least six months after successful dilatation. Failure of dilatation was defined as one of the following; complete luminal stenosis, inability to perform safe dilatation, perforation, and inability to maintain adequate luminal patency. Surgery or repeated dilatation was indicated in failed dilatations. There were 55 patients with corrosive esophageal strictures. Of 55 patients, 41 (75%) had failed dilatation (38 having esophageal replacement procedure, two continue repeated dilatation and one unfit for surgery). Of 323 sessions of dilatations, eight out of 55 patients (14.5%) had perforations. There was no dilatation-related mortality. Patients with concomitant pharyngeal stricture (p = 0.0001), long (= 10 cm) stricture length (p 0.0001), number of dilatation 6 sessions per year (p = 0.01) and refractory stricture (inability to pass a larger than 11 mm dilator within three sessions) (p = 0.01) were more likely to have failed dilatation. Thirty-two of 38 patients with surgery had good swallow outcome with one operative mortality (2.6%). At the median follow-up of 61 months, overall favorable outcome was 84% after surgery and 25% for dilatation (p 0.0001). Majority of patients with acid-induced corrosive esophageal stricture were refractory to dilatation. Esophageal dilatations were ultimately failed in three-fourth of the patients. Concomitant cricopharyngeal stricture, long stricture length, requiring frequent dilatation, and refractory to 11 mm dilatation were factors associated with failed dilatation.
机译：酸性腐蚀性食管狭窄中内窥镜扩张的结果较少。本研究旨在确定酸诱导的腐蚀性食管狭窄患者失败的扩张和预测因子的结果。包括诊断出腐蚀性食管狭窄的患者。用分级蔗渣扩张器的内窥镜扩张作为第一线处理。当患者能够在成功扩张后至少六个月后，患者能够吞咽固体而无需吞咽固体，扩张的结果被认为是有利的。扩张失败被定义为以下之一;完全羽毛狭窄，无法进行安全扩张，穿孔，无法保持足够的腔漏洞。手术或反复扩张在失败中表明失败。有55名患者腐蚀性食管狭窄。 55例患者中，41例（75％）的扩张失败（38例具有食管替代程序，两种继续反复扩张，一个不适合手术）。 323个膨胀会，55名患者中有八个（14.5％）有穿孔。没有膨胀相关的死亡率。伴随咽部狭窄的患者（p = 0.0001），长（＆ = 10cm）狭窄长度（p＆ 0.0001），扩张次数>每年6次会议（P = 0.01）和难治性狭窄（无法通过a在三个会话范围内大于11毫米的扩张器）（P = 0.01）更可能进行失败的扩张。 38例手术患者中有38名患者具有良好的吞咽结果，具有一种手术死亡率（2.6％）。在61个月的中位随访中，手术后总体有利结果为84％，膨胀25％（P <0.0001）。酸性诱导的腐蚀性食管狭窄的大多数患者是扩张的难治性。食管膨胀最终在患者的四分之三最终失败。伴随的症状狭窄，长度长，需要频繁扩张，难以解决，令人难以置疑的令人难以置的扩张性是与扩张失灵失败相关的因素。

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