Outpatient dilation of anastomotic strictures of the upper gastrointestinal tract.
Anastomotic upper gastrointestinal strictures in 32 patients were dilated on an outpatient basis. Strictures had developed following resection-anastomosis of the esophagus in 27, total esophagectomy in two and total/partial gastrectomy in three patients. Patients with benign anastomotic strictures (group A; n = 21) presented within 6 (median 2) months of surgery while those with recurrent tumors at the site of anastomosis (group B; n = 11) presented 7 (median 14) months later. Dilation using Savary-Gilliard (n = 24), through the scope balloon (n = 2) and Eder Puestow (n = 1) dilators or a combination of these (n = 1) was possible in 20 (95%) patients in group A and 8 (73%) patients in group B. All the 28 patients had relief of dysphagia. Median duration of response after first dilation was 4.2 and 1.2 months in groups A and B respectively. Nature of previous surgery, length of the remaining stomach and recurrence of tumor at anastomosis appeared to affect the technique and outcome of dilation. Savary-Gilliard dilators can be used in a majority of patients except those with short stomachs where through the scope balloon dilators may be preferred.
Desai
D C
DC
Department of Medical Gastroenterology, Tata Memorial Hospital, Parel, Bombay.
Swaroop
V S
VS
Mohandas
K M
KM
Dhir
V
V
Nagral
A
A
Deshpande
R
R
Desai
P B
PB
D003680:Deglutition Disorders / Q000628:therapy; D004106:Dilatation / Q000379:methods*; D004940:Esophageal Stenosis / Q000209:etiology / Q000628:therapy*; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000601:surgery; D006801:Humans; D008297:Male; D010045:Outpatients; D011183:Postoperative Complications