Non-operative treatment of benign oesophageal strictures: results after endoscopic balloon dilatation and H2-antagonists.

OBJECTIVE

To evaluate the success of non-operative treatment of benign oesophageal strictures.

DESIGN

Retrospective study.

SETTING

University department of surgery.

SUBJECTS

27 consecutive patients with benign oesophageal strictures treated between 1984 and 1989.

INTERVENTIONS

Repeated oesophageal dilatations as necessary together with cimetidine or ranitidine; 10 patients underwent 24 hour pH measurements.

MAIN OUTCOME MEASURES

Resolution of dysphagia and gastro-oesophageal reflux.

RESULTS

125 dilatations were done for the 27 patients, 21 patients required four or less. The longer the stricture the larger the number of dilatations required. Median follow up time was 27 months (range 3-74), and during this period 11 patients died. None of the deaths was related either to the stricture or to its treatment. There were no complications of dilatation. Among the 10 patients who underwent 24 hour pH measurements the median percentage of time that the pH was less than 4 was 23, range 7-67. Non-operative treatment was successful in all but three patients, who required fundoplication.

CONCLUSIONS

Non-operative treatment is successful for most patients with benign strictures, so it may be possible to restrict antireflux operations to young patients with strictures.