title: Outpatient dilation of anastomotic strictures of the upper gastrointestinal tract.
abstract: 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.
authors.affiliation: Department of Medical Gastroenterology, Tata Memorial Hospital, Parel, Bombay.
authors.forename: D C
authors.initials: DC
authors.lastname: Desai
authors.forename: V S
authors.initials: VS
authors.lastname: Swaroop
authors.forename: K M
authors.initials: KM
authors.lastname: Mohandas
authors.forename: V
authors.initials: V
authors.lastname: Dhir
authors.forename: A
authors.initials: A
authors.lastname: Nagral
authors.forename: R
authors.initials: R
authors.lastname: Deshpande
authors.forename: P B
authors.initials: PB
authors.lastname: Desai
mesh_terms: 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