Center for Esophageal Diseases and Swallowing, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.
Gastrointest Endosc. 2010 Apr;71(4):706-12. doi: 10.1016/j.gie.2009.10.047. Epub 2010 Feb 18.
Esophageal strictures resulting from eosinophilic esophagitis present management challenges, and high rates of rents and perforation have been reported.
To assess the safety of esophageal dilation in eosinophilic esophagitis and to characterize predictors of both clinical response and complications of the procedure.
Retrospective study of the University of North Carolina eosinophilic esophagitis database.
Tertiary care referral center.
Cases of eosinophilic esophagitis were defined as per consensus guidelines.
Dilation with either Savary or through-the-scope balloon techniques.
Complications (deep mucosal rents, contained or free perforation, and chest pain requiring medical attention or hospitalization) and the global clinical symptom response.
Of 130 eosinophilic esophagitis cases identified, 70 dilations (12 Savary, 58 balloon) were performed in 36 patients. Esophageal size improved from 12 to 16 mm (P < .001), with an overall symptom response rate of 83%. The only predictor of clinical response was final dilation diameter. There were 5 complications (7%): 2 deep mucosal rents and 3 episodes of chest pain. There were no perforations. There was one hospitalization for chest pain. All complications occurred in patients being treated with topical steroids, who underwent balloon dilation. Complications were associated with younger age (23 vs 42; P = .02) and more dilations (4 vs 1.7; P = .009).
Single center, retrospective study.
Esophageal dilation can be performed in eosinophilic esophagitis with low rates of tears, chest pain, and hospitalization. No perforations were found in our database. The effectiveness of dilation was best when a larger esophageal caliber was achieved, but patients undergoing more procedures was associated with complications.
嗜酸性粒细胞性食管炎导致的食管狭窄在治疗上具有挑战性，且已有报道称其存在较高的穿孔和撕裂风险。
评估食管扩张术治疗嗜酸性粒细胞性食管炎的安全性，并确定临床疗效和操作相关并发症的预测因素。
回顾性研究，分析北卡罗来纳大学嗜酸性粒细胞性食管炎数据库。
三级转诊中心。
符合共识指南的嗜酸性粒细胞性食管炎病例。
使用 Savary 扩张器或经内镜球囊扩张。
并发症（深度黏膜撕裂、包裹性或游离性穿孔、胸痛需要医疗干预或住院）和整体临床症状缓解。
共纳入 130 例嗜酸性粒细胞性食管炎病例，其中 36 例患者共接受了 70 次扩张治疗（12 次 Savary 扩张，58 次经内镜球囊扩张）。食管直径从 12 毫米增加到 16 毫米（P＜0.001），总体症状缓解率为 83%。临床疗效的唯一预测因素是最终扩张直径。共有 5 例并发症（7%）：2 例深度黏膜撕裂，3 例胸痛。无穿孔病例，1 例因胸痛住院。所有并发症均发生在接受局部皮质类固醇治疗的患者中，且均行经内镜球囊扩张。并发症与患者年龄较轻（23 岁比 42 岁；P=0.02）和接受更多次扩张（4 次比 1.7 次；P=0.009）相关。
单中心、回顾性研究。
在嗜酸性粒细胞性食管炎患者中进行食管扩张术的并发症发生率低，包括撕裂、胸痛和住院。在本数据库中未发现穿孔。扩张效果最好的情况是获得更大的食管直径，但进行更多次扩张与并发症相关。
