Outcome of endoscopic therapeutic interventions: are they different among various non-malignant esophageal diseases.
BACKGROUND
This study was carried out to evaluate and compare the outcome of various causes of non-malignant lesions of the esophagus after endoscopic therapeutic intervention.


METHODS
A cohort of patients with non-malignant dysphagia presenting at Aga Khan University hospital, a tertiary care setting who underwent endoscopic intervention was studied. Response to treatment was evaluated by improvement in dysphagia score on a scale of 0-4 and weight gain.


RESULTS
99 subjects (53 males) were included. Mean age was 48.6 +/- 17.2 years. Dysphagia for solids was present in 48%, for liquids in 3% and for both in 49% patients. Significant weight loss (>10% body weight) occurred in 35 (35.3%) patients. Achalasia was diagnosed in 49.5%, peptic stricture in 30.4%, post sclerotherapy stricture in 12.1%, corrosive injury in 4%, post-operative stricture in 4%. In comparative analysis of achalasia and inflammatory groups, good response to dysphagia was seen in 40/49 (82%) and 22/50 (44%) respectively p < 0.001. Weight gain was 35/49 (72%) and 22/50 (44%) p <0.001 respectively. Significantly, more endoscopic sessions were required in inflammatory group compare to achalasia; 2.2 and 1.1 respectively; p <0.001 and 160% complications rate in inflammatory group comparing to no complications in achalasia.


CONCLUSIONS
Dysphagia and weight loss were common presentations in non-malignant esophageal diseases. Therapeutic intervention in inflammatory group was associated with high complication than the achalasia group.
Khan
Rustam
R
Section of Gastroenterology. Department of Medicine. The Aga Khan University Hospital, Karachi, Pakistan.
Abid
Shahab
S
Hamid
Saeed
S
Abbas
Zaigham
Z
Shah
Hasnain
H
Jafri
Wasim
W
D003680:Deglutition Disorders / Q000209:etiology*; D004931:Esophageal Achalasia / Q000209:etiology*; D004935:Esophageal Diseases / Q000601:surgery*; D004945:Esophagoscopy / Q000009:adverse effects*; D004947:Esophagus / Q000293:injuries*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D016896:Treatment Outcome; D015431:Weight Loss