Department of Gastroenterology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Dig Endosc. 2013 Sep;25(5):490-5. doi: 10.1111/den.12023. Epub 2012 Dec 26.
Endoscopic procedures, such as balloon/bougie dilation and stent implantation, have gained increasing potential as the treatment of corrosive esophageal stricture. The purpose of the present retrospective case series study was to assess clinical outcomes of endoscopic therapy of esophageal strictures after caustic injury.
Between January 2003 and December 2009, 13 admitted patients that developed esophageal stricture after caustic agent ingestion underwent endoscopic therapy at the First Affiliated Hospital of Nanjing Medical University. Data such as age, gender, caustic agents, site of burn, type of treatment, effectiveness and outcome of endoscopic therapy were recorded.
The average follow up was 39 months with a range of 29-70 months. Successful endoscopic therapy was achieved in 12 of 13 patients (92%). Duration of stricture resolution was between 4 and 48 months (mean, 15 months). Among them, seven patients required dilations only, whereas the other five patients received both dilations and stent implantation. There were no severe complications in these patients.
These data suggest that endoscopic therapy is feasible, less invasive and effective for the management of caustic esophageal stricture. After repeat dilation and stenting, patients can achieve stricture resolution in approximately 15 months and avoid surgery.
内镜治疗,如球囊/探条扩张和支架植入,已成为腐蚀性食管狭窄的一种越来越有潜力的治疗方法。本回顾性病例系列研究的目的是评估腐蚀性食管损伤后内镜治疗食管狭窄的临床效果。
2003 年 1 月至 2009 年 12 月,在南京医科大学第一附属医院接受内镜治疗的 13 例腐蚀性药物摄入后发生食管狭窄的患者,被纳入本研究。记录了年龄、性别、腐蚀性药物、烧伤部位、治疗类型、内镜治疗的有效性和结果等数据。
平均随访时间为 39 个月,范围为 29-70 个月。13 例患者中有 12 例(92%)内镜治疗成功。狭窄缓解时间为 4 至 48 个月(平均 15 个月)。其中,7 例仅接受扩张治疗,而其余 5 例则同时接受扩张和支架植入治疗。这些患者均无严重并发症。
这些数据表明,内镜治疗是腐蚀性食管狭窄的一种可行、微创且有效的治疗方法。在重复扩张和支架植入后,患者可在约 15 个月内实现狭窄缓解,并避免手术。