| Autor: |
Hammoudi, Nassim, Giaoui, Audrey, Lambert, Jérôme, Dhooge, Marion, Corte, Hélène, Tran-Minh, My-Linh, Cattan, Pierre, Gornet, Jean-Marc |
| Předmět: |
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| Zdroj: |
Surgical Endoscopy & Other Interventional Techniques; Aug2022, Vol. 36 Issue 8, p5660-5668, 9p |
| Abstrakt: |
Background: Predictors of the efficacy of endoscopic dilation for caustic esophageal stricture have been poorly studied.Methods: All patients undergoing an endoscopic dilation for an esophageal caustic stricture between 1990 and 2015 in a French national reference center were included. Success of dilation was defined by self-food autonomy without the need for reconstructive esophageal surgery.Results: During the study period, 894 patients were admitted after caustic ingestion. Among them, 101 patients developed esophageal stricture and 92 patients were eligible for analysis (missing data in 8 cases, 1 patient died before endoscopic dilation). In this cohort (median age 42 years, women 53%, strong alkali 74%, suicide attempt 77%, hydrostatic balloon use 93%), the overall success rate of dilation was 57% with a median number of 3 dilation sessions (274 sessions, range 1-17). Factors predicting the success of the procedure were: non-inflammatory stricture or non-inflammatory intercalated mucosa between stricture (88% vs 47%, p = 0.001), a single stricture versus 2 or more strictures (69% vs 47% vs 33%, respectively, p = 0.04), a stricture of less than 5 cm (70% vs 27%, p < 0.001) and the existence of mild/ moderately tight or very tight stricture (70% vs 21% of success, p < 0.001). Perforation rate was 6.5% (18/274) requiring emergency surgery in 2 cases.Conclusion: Several characteristics of caustic esophageal strictures are significantly associated with the success rate of endoscopic dilation. Our data may be useful for customizing treatment strategies in patients with a caustic stricture. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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