Lanza F L, Graham D Y
JAMA. 1978 Sep 1;240(9):844-7.
Esophageal stricture is the most frequent serious complication of reflux esophagitis. Bougienage was used as the primary therapy of benign esophageal stricture in 92 patients, followed by institution of a medical antireflux program. Response to treatment was excellent, and 78% of patients required two or fewer subsequent dilations. Twenty patients were followed up for two years or longer, and 75% did not require more than one dilation annually. Primary therapy for most patients with peptic stenosis of the esophagus is recommended to be dilation; operative therapy should be reserved for those patients in whom a malignant neoplasm is suspected or those in whom frequent and rapid stricture recurrence makes medical therapy impractical.
食管狭窄是反流性食管炎最常见的严重并发症。对92例良性食管狭窄患者采用探条扩张术作为主要治疗方法,随后实施抗反流药物治疗方案。治疗效果极佳,78%的患者后续扩张次数为两次或更少。20例患者随访两年或更长时间,75%的患者每年扩张次数不超过一次。对于大多数患有消化性食管狭窄的患者,建议主要治疗方法为扩张;手术治疗应保留给怀疑有恶性肿瘤的患者或频繁且迅速复发狭窄导致药物治疗不切实际的患者。