Department of Gastroenterology, Nehru Hospital, Postgraduate Institute of Medical Education and Research (PGIMER), Sector-12, Chandigarh, 160012, India.
Department of Gastroenterology, STAR Hospital, Nanakramguda, Hyderabad, India.
Surg Endosc. 2023 Nov;37(11):8236-8244. doi: 10.1007/s00464-023-10384-4. Epub 2023 Aug 31.
Endoscopic dilation is the preferred management strategy for caustic esophageal strictures (CES). However, the differences in outcome for different dilators are not clear. We compared the outcome of CES using bougie and balloon dilators.
Between January 2000 and December 2016, the following data of all the patients with CES were collected: demographic parameters, substance ingestion, number of strictures, number of dilations required to achieve ≥ 14 mm dilation, post-dilation recurrence, and total dilations. Patients were divided into two groups for the type of dilator, i.e., bougie or balloon. The two groups were compared for baseline parameter, technical success, short- and long-term clinical success, refractory strictures, recurrence rates, and major complications.
Of the 189 patients (mean age 32.17 ± 12.12 years) studied, 119 (62.9%) were males. 122 (64.5%) patients underwent bougie dilation and 67 (35.5%) received balloon dilation. Technical success (90.1% vs. 68.7%, p < 0.001), short-term clinical success (65.6% vs. 46.3%, p value 0.01), and long-term clinical success (86.9% vs. 64.2%, p < 0.01) were higher for bougie dilators compared to balloon dilators. Twenty-four (12.7%) patients developed adverse events which were similar for two groups. On multivariate analysis, use of bougie dilators (aOR 4.868, 95% CI 1.027-23.079), short-term clinical success (aOR 5.785, 95% CI 1.203-27.825), and refractory strictures (aOR 0.151, 95% CI 0.033-0.690) were independent predictors of long-term clinical success.
Use of bougie dilators is associated with better clinical success in patients with CES compared to balloon dilators with similar rates of adverse events.
内镜扩张是治疗腐蚀性食管狭窄（CES）的首选治疗策略。然而，不同扩张器的结果差异尚不清楚。我们比较了使用探条和球囊扩张器治疗 CES 的结果。
在 2000 年 1 月至 2016 年 12 月期间，收集了所有 CES 患者的以下数据：人口统计学参数、物质摄入、狭窄数量、达到≥14mm 扩张所需的扩张次数、扩张后复发和总扩张次数。根据扩张器类型将患者分为探条组或球囊组。比较两组的基线参数、技术成功率、短期和长期临床成功率、难治性狭窄、复发率和主要并发症。
在 189 名患者（平均年龄 32.17±12.12 岁）中，119 名（62.9%）为男性。122 名（64.5%）患者接受探条扩张，67 名（35.5%）接受球囊扩张。探条扩张的技术成功率（90.1%比 68.7%，p<0.001）、短期临床成功率（65.6%比 46.3%，p 值<0.01）和长期临床成功率（86.9%比 64.2%，p<0.01）均高于球囊扩张。24 名（12.7%）患者发生不良事件，两组相似。多变量分析显示，使用探条扩张器（OR 4.868，95%CI 1.027-23.079）、短期临床成功率（OR 5.785，95%CI 1.203-27.825）和难治性狭窄（OR 0.151，95%CI 0.033-0.690）是长期临床成功的独立预测因素。
与球囊扩张器相比，探条扩张器在 CES 患者中具有更好的临床成功率，且不良事件发生率相似。
