Desai D C, Swaroop V S, Mohandas K M, Dhir V, Nagral A, Sharma V, Deshpande R, Dinshaw K A, Desai P B
Division of Medical Gastroenterology, Tata Memorial Hospital, Parel, Bombay.
Indian J Gastroenterol. 1992 Apr;11(2):65-7.
Experience of outpatient esophageal dilation using Savary-Gilliard dilators in 130 patients during a 17 month period is reported. The strictures were radiation induced (48), tumoral stenoses (40), anastomotic (16) and due to other causes (26). Both fluoroscopy and endoscopy were used in 58%, endoscopy alone in 23% and fluoroscopy alone in 19% of patients for placement of the guide wire. One hundred and twenty six stricture dilations (97%) were technically successful. Eighty one (62%) patients could be dilated to 14 mm or more. One hundred and nineteen (94%) patients were dilated in one or two sessions. Among the 109 patients who followed up, dilation was successful in providing adequate dysphagia relief in 97 patients and facilitated the performance of other therapies in 9 patients. Major complications included severe continuous chest pain (1 case), hematemesis (2), fever (4) and transient stridor (2). The patient with persistent pain and 9 patients undergoing other therapies required hospitalization. There were no perforations or death. We conclude that esophageal dilation with Savary-Gilliard dilators is safe and effective even in tumors and post-radiation strictures. It can be performed on an outpatient basis in a majority of patients.
报告了在17个月期间使用Savary-Gilliard扩张器对130例患者进行门诊食管扩张的经验。狭窄原因包括放疗引起（48例）、肿瘤性狭窄（40例）、吻合口狭窄（16例）以及其他原因（26例）。58%的患者在放置导丝时同时使用了荧光镜检查和内镜检查，23%的患者仅使用了内镜检查，19%的患者仅使用了荧光镜检查。126例狭窄扩张（97%）在技术上取得成功。81例（62%）患者能够扩张至14毫米或更宽。119例（94%）患者在一至两次治疗中完成扩张。在接受随访的109例患者中，扩张成功使97例患者吞咽困难得到充分缓解，并使9例患者能够接受其他治疗。主要并发症包括严重持续性胸痛（1例）、呕血（2例）、发热（4例）和短暂性喘鸣（2例）。持续性疼痛患者和9例接受其他治疗的患者需要住院治疗。未发生穿孔或死亡。我们得出结论，即使在肿瘤和放疗后狭窄患者中，使用Savary-Gilliard扩张器进行食管扩张也是安全有效的。大多数患者可在门诊进行。
