Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.
Cancer Biomarker Group, Swansea Medical School, Swansea University, Swansea, UK.
Gut. 2018 Jun;67(6):1000-1023. doi: 10.1136/gutjnl-2017-315414. Epub 2018 Feb 24.
These are updated guidelines which supersede the original version published in 2004. This work has been endorsed by the Clinical Services and Standards Committee of the British Society of Gastroenterology (BSG) under the auspices of the oesophageal section of the BSG. The original guidelines have undergone extensive revision by the 16 members of the Guideline Development Group with representation from individuals across all relevant disciplines, including the Heartburn Cancer UK charity, a nursing representative and a patient representative. The methodological rigour and transparency of the guideline development processes were appraised using the revised Appraisal of Guidelines for Research and Evaluation (AGREE II) tool.Dilatation of the oesophagus is a relatively high-risk intervention, and is required by an increasing range of disease states. Moreover, there is scarcity of evidence in the literature to guide clinicians on how to safely perform this procedure. These guidelines deal specifically with the dilatation procedure using balloon or bougie devices as a primary treatment strategy for non-malignant narrowing of the oesophagus. The use of stents is outside the remit of this paper; however, for cases of dilatation failure, alternative techniques-including stents-will be listed. The guideline is divided into the following subheadings: (1) patient preparation; (2) the dilatation procedure; (3) aftercare and (4) disease-specific considerations. A systematic literature search was performed. The Grading of Recommendations Assessment, Develop-ment and Evaluation (GRADE) tool was used to evaluate the quality of evidence and decide on the strength of recommendations made.
这些是更新后的指南，取代了 2004 年发表的原始版本。这项工作得到了英国胃肠病学会（BSG）临床服务和标准委员会的认可，该委员会是在 BSG 的食管分会的主持下开展的。原始指南经过指南制定小组的 16 名成员的广泛修订，代表了来自所有相关学科的个人，包括英国胃灼热癌症慈善机构、一名护理代表和一名患者代表。使用修订后的评估研究和评估指南（AGREE II）工具评估了指南制定过程的方法学严谨性和透明度。食管扩张是一种风险相对较高的干预措施，越来越多的疾病状态需要进行这种干预。此外，文献中几乎没有证据可以指导临床医生如何安全地进行该程序。这些指南专门针对使用球囊或探条设备进行扩张程序，作为治疗非恶性食管狭窄的主要治疗策略。支架的使用不在本文的范围内；然而，对于扩张失败的病例，将列出替代技术，包括支架。该指南分为以下小标题：（1）患者准备；（2）扩张程序；（3） 后续护理和（4）特定疾病的考虑。进行了系统的文献检索。使用推荐评估、制定和评估（GRADE）工具评估证据质量，并决定提出的建议的强度。
