Burr Nicholas E, Everett Simon M
Leeds Gastroenterology Institute, St James's University Hospital, Leeds, UK.
Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, Leeds, UK.
Frontline Gastroenterol. 2019 Apr;10(2):177-181. doi: 10.1136/flgastro-2018-101075. Epub 2019 Jan 7.
Benign oesophageal strictures are an important gastrointestinal condition that can cause substantial morbidity. There are many different aetiologies and each case needs careful evaluation and individualised treatment. Management usually involves targeting therapy to the underlying cause, but oesophageal dilatation is an important part of the algorithm. The recent British Society of Gastroenterology guidelines provide advice on the use of dilatation for benign strictures and cover patient preparation, the dilatation procedure and disease-specific considerations. This article provides a summary of the key messages from the guidelines and applies them to routine clinical practice. It also includes practical advice on the clinical assessment, investigation and management of benign oesophageal strictures and gives an approach to the management of refractory strictures. Areas where evidence is sparse and further research is needed are highlighted.
良性食管狭窄是一种重要的胃肠道疾病,可导致严重的发病率。其病因众多,每个病例都需要仔细评估并进行个体化治疗。治疗通常包括针对潜在病因进行治疗,但食管扩张是治疗方案的重要组成部分。英国胃肠病学会最近发布的指南就良性狭窄的扩张治疗提供了建议,涵盖患者准备、扩张操作及特定疾病的注意事项。本文总结了该指南的关键信息并将其应用于日常临床实践。文中还包括关于良性食管狭窄的临床评估、检查和治疗的实用建议,并给出了难治性狭窄的处理方法。文中突出了证据不足且需要进一步研究的领域。