Long-term recurrence rates following dilation of symptomatic Schatzki rings.
OBJECTIVE
This study investigated the long-term clinical course of patients with Schatzki rings, who were treated by single bougie dilation. Furthermore, it analyzed possible predictors for the time of recurrence.


METHODS
A total of 133 patients (100 males, 33 females) with a mean age of 57 ± 14.6 years who were treated by single dilation with the use of Maloney bougies without the aid of fluoroscopy were prospectively registered and followed-up for a mean duration of 58.3 months (range 12-240 months). Duration of remission was evaluated by Kaplan-Meier estimates with regard to recurrence. Log-rank test was performed to analyze possible predictors for the time to second dilation (recurrence).


RESULTS
No complications occurred and all patients were symptom-free at the first follow-up examination 4 weeks after dilation. However, later on, 73 patients required a second dilation. The estimate remission rates were 63.8% (95% CI: 55.6-72.0%) after 2 years, 44.3% (95% CI: 35.4-53.4%) after 5 years, and 39.9% (95% CI: 30.5-49.3%) after 10 years. Neither the initial morphological findings, nor age or gender determined the need for repeated dilation. Only patients treated with a large bougie diameter (≥52 F) seemed to have a tendency for a longer time until symptomatic recurrence.


CONCLUSIONS
Single dilation of symptomatic Schatzki rings is a safe and effective therapy. However, more than half of the patients will need a second treatment. Recurrences are unrelated to initial morphological findings, age, or gender. Only the treatment with a large bougie diameter (≥52 F) showed a tendency for a longer time of remission.
Department of Gastroenterology, Deutsche Klinik für Diagnostik, Aukammallee 33, 65191, Wiesbaden, Germany. mueller.gastro@dkd-wiesbaden.de
Michaela
M
Müller
Ines
I
Gockel
Jochem
J
König
Kathrin
K
Kuhr
Volker F
VF
Eckardt
D000328:Adult; D000368:Aged; D004106:Dilatation / Q000379:methods*; D004940:Esophageal Stenosis / Q000601:surgery*; D004943:Esophagogastric Junction / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence