Stoner Patrick L, Fullerton Amy L, Freeman Alyssa M, Chheda Neil N, Estores David S
Medicine, University of Florida, 1600 SW Archer Rd, Gainesville, FL 32610, USA.
Speech, Language, and Hearing Sciences, University of Florida, 1600 SW Archer Rd, Gainesville, FL 32610, USA.
Gastroenterol Res Pract. 2019 May 28;2019:8905615. doi: 10.1155/2019/8905615. eCollection 2019.
Endoscopic dilation of postlaryngectomy strictures (PLS) is safe and effective; however, PLS are often refractory and require serial dilations. Long-term outcomes of dilation in patients with refractory PLS are not well reported.
Seven patients with dysphagia and refractory PLS underwent serial endoscopic dilation therapy during a 4.5-year period. Dilation characteristics, technical success, clinical success, and diet advancement (as assessed by Diet/GT scale) were measured. All strictures were complex, and there were no reported complications. The median number of dilations per patient was 12 (range 7 to 48). The average interval in between dilations was six weeks. Technical success was achieved in 6/7 patients, and clinical success was achieved in 2/7 patients. 6/7 patients had advancements in Diet/GT scores.
Dilation of refractory PLS is safe and effective and frequently requires the use of a retrograde approach, fluoroscopic guidance, and/or lumen patency strings. Serial dilations are required to maintain luminal patency, relieve dysphagia, and advance oral diet. The definition of clinical success of dilation in these patients should avoid the use of a specific time interval between dilations to characterize success.
喉切除术后狭窄（PLS）的内镜扩张术安全有效；然而，PLS往往难以治疗，需要多次扩张。难治性PLS患者扩张的长期结果报道较少。
7例吞咽困难且难治性PLS患者在4.5年期间接受了多次内镜扩张治疗。测量了扩张特征、技术成功率、临床成功率和饮食进展情况（通过饮食/吞咽困难分级量表评估）。所有狭窄均较为复杂，且未报告并发症。每位患者的扩张次数中位数为12次（范围为7至48次）。扩张之间的平均间隔为6周。6/7例患者获得技术成功，2/7例患者获得临床成功。6/7例患者的饮食/吞咽困难分级量表评分有所提高。
难治性PLS的扩张术安全有效，且经常需要采用逆行方法、透视引导和/或管腔通畅线。需要多次扩张以维持管腔通畅、缓解吞咽困难并促进经口饮食。这些患者扩张临床成功的定义应避免使用扩张之间的特定时间间隔来界定成功。
