Endoscopic dexamethasone injection following balloon dilatation of anastomotic stricture after esophagogastrostomy.
BACKGROUND
Anastomotic stricture is common after esophagogastrostomy. Recent advances in nonsurgical treatment include the silicon bougie and balloon dilatation. However, simple dilatation alone with a silicon bougie or endoscopic balloon dilator was repeated a mean of 4.7+/-5.4 times to control anastomotic stricture because of its temporary effect.


METHODS
For 11 patients, endoscopic injection of dexamethasone (8 mg) around the anastomosis was done immediately after balloon dilatation (40 psi for 5 minutes).


RESULTS
This method significantly reduced the number of the dilatations to 1.1+/-0.3 (P < 0.05). Ten of the 11 patients did not need any further treatment. There were no side effects or complications of dexamethasone injection.


CONCLUSIONS
A combination of endoscopic balloon dilatation and dexamethasone injection provided an easy and safe method for preventing the recurrence of anastomotic stricture.
Miyashita
M
M
First Department of Surgery, Nippon Medical School, Tokyo, Japan.
Onda
M
M
Okawa
K
K
Matsutani
T
T
Yoshiyuki
T
T
Sasajima
K
K
Kyono
S
S
Yamashita
K
K
D000714:Anastomosis, Surgical; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D002404:Catheterization; D003131:Combined Modality Therapy; D003251:Constriction, Pathologic / Q000628:therapy; D003907:Dexamethasone / Q000008:administration & dosage* / Q000627:therapeutic use; D004938:Esophageal Neoplasms / Q000601:surgery; D004947:Esophagus / Q000601:surgery*; D005260:Female; D005774:Gastrostomy; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000628:therapy*
D000893:Anti-Inflammatory Agents; D003907:Dexamethasone