title: Use of a very flexible guide wire to permit dilation of complex malignant strictures of the esophagus.
abstract: Risk of perforation is a major impediment to the use of polyvinyl bougies in palliative dilation of cancerous strictures of the esophagus. We encountered 23 patients with complex malignant strictures in whom initial dilation with Savary-Gilliard bougies was thwarted because attempts to pass a conventional Eder-Puestow guide wire were unsuccessful. As a recourse, we probed these strictures with a very flexible guide wire of the type used to implant prostheses in the biliary tract. The purpose was to establish a passage through which a standard guide wire could then be inserted. The procedure was successful in all but 4 of the 23 patients. We conclude that in such cases the preliminary use of the very flexible guide, even though time-consuming, improves the chance of effective dilation with minimal added risk.
authors.affiliation: Departamento de Gastroenterología, Servicio de Medicina y Servicio de Radiología, Hospital San Juan de Dios, Universidad de Chile.
authors.forename: L
authors.initials: L
authors.lastname: Vargas-Tank
authors.forename: L
authors.initials: L
authors.lastname: Ovalle
authors.forename: C
authors.initials: C
authors.lastname: Fernández
authors.forename: B
authors.initials: B
authors.lastname: Mella
authors.forename: R
authors.initials: R
authors.lastname: Estay
authors.forename: M P
authors.initials: MP
authors.lastname: del Solar
authors.forename: J R
authors.initials: JR
authors.lastname: Soto
mesh_terms: D004106:Dilatation / Q000295:instrumentation / Q000379:methods; D004938:Esophageal Neoplasms / Q000150:complications*; D004940:Esophageal Stenosis / Q000209:etiology / Q000628:therapy*; D006801:Humans; D010166:Palliative Care