Albany Medical Center, 43 New Scotland Avenue, Albany, NY, 12208, USA.
University of Connecticut Health, 263 Farmington Ave, Farmington, CT, 06030, USA.
Esophagus. 2021 Oct;18(4):908-914. doi: 10.1007/s10388-021-00838-w. Epub 2021 Apr 12.
Eosinophilic esophagitis (EoE) causes esophageal narrowing and strictures, but factors that modify the severity of strictures and requirement for subsequent dilation are not well described. The aim of this study was to identify characteristics that impact the need for repeat (> 1) esophageal dilations in EoE patients.
This was a single center retrospective cohort study over a 12-year period (September 2005-October 2017). Patients were identified using ICD9, ICD10, and CPT codes for esophageal dilation, eosinophilic esophagitis, and esophageal obstruction. Data for EoE clinical characteristics, treatments, and BMI were extracted and correlated to the number of esophageal dilations and time elapsed between dilations.
Of the 21 patients who met inclusion criteria, 11 (52%) had at least two dilations and 9 (43%) had three dilations. There was no differences baseline demographics between patients who needed ≥ 2 vs. those who needed one dilation. However, patients with a BMI > 30 had a significantly longer median time to second dilation compared to non-obese patients (4.9 years vs. 1.8 years; p = 0.027). Stratification by either high dose PPI or inhaled steroid use did not change this result.
EoE patients with strictures who are obese have a reduced requirement for subsequent esophageal dilation. While the mechanism for this is not clear, increased attention of non-obese patients with fibrostenotic EoE is indicated as they are at higher risk for recurrent strictures.
嗜酸性食管炎（EoE）可导致食管狭窄和狭窄，但尚未充分描述影响狭窄严重程度和后续扩张需求的因素。本研究旨在确定影响 EoE 患者需要重复（>1 次）食管扩张的特征。
这是一项为期 12 年（2005 年 9 月至 2017 年 10 月）的单中心回顾性队列研究。通过 ICD9、ICD10 和 CPT 代码识别食管扩张、嗜酸性食管炎和食管梗阻的患者。提取 EoE 临床特征、治疗和 BMI 的数据，并将其与食管扩张次数和两次扩张之间的时间间隔相关联。
在符合纳入标准的 21 名患者中，有 11 名（52%）至少接受了两次扩张，有 9 名（43%）接受了三次扩张。需要≥2 次扩张与需要 1 次扩张的患者在基线人口统计学特征方面没有差异。然而，BMI>30 的患者第二次扩张的中位时间明显长于非肥胖患者（4.9 年 vs. 1.8 年；p=0.027）。无论高剂量 PPI 还是吸入性类固醇的使用分层，都没有改变这一结果。
肥胖的 EoE 患者伴有狭窄，对后续食管扩张的需求降低。虽然其机制尚不清楚，但需要增加对非肥胖的纤维化 EoE 患者的关注，因为他们的复发性狭窄风险更高。
