Endoscopic therapy in the treatment of caustic esophageal stricture: a retrospective case series study.
BACKGROUND
Endoscopic procedures, such as balloon/bougie dilation and stent implantation, have gained increasing potential as the treatment of corrosive esophageal stricture. The purpose of the present retrospective case series study was to assess clinical outcomes of endoscopic therapy of esophageal strictures after caustic injury.


METHODS
Between January 2003 and December 2009, 13 admitted patients that developed esophageal stricture after caustic agent ingestion underwent endoscopic therapy at the First Affiliated Hospital of Nanjing Medical University. Data such as age, gender, caustic agents, site of burn, type of treatment, effectiveness and outcome of endoscopic therapy were recorded.


RESULTS
The average follow up was 39 months with a range of 29-70 months. Successful endoscopic therapy was achieved in 12 of 13 patients (92%). Duration of stricture resolution was between 4 and 48 months (mean, 15 months). Among them, seven patients required dilations only, whereas the other five patients received both dilations and stent implantation. There were no severe complications in these patients.


CONCLUSIONS
These data suggest that endoscopic therapy is feasible, less invasive and effective for the management of caustic esophageal stricture. After repeat dilation and stenting, patients can achieve stricture resolution in approximately 15 months and avoid surgery.
Department of Gastroenterology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Cuiling
C
Zhang
Xiaoying
X
Zhou
Lianzhen
L
Yu
Jing
J
Ding
Ruihua
R
Shi
D000328:Adult; D002057:Burns, Chemical / Q000209:etiology / Q000628:therapy*; D002424:Caustics / Q000009:adverse effects; D002648:Child; D002681:China; D015331:Cohort Studies; D004106:Dilatation / Q000379:methods*; D004940:Esophageal Stenosis / Q000139:chemically induced* / Q000628:therapy*; D004945:Esophagoscopy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015601:Injury Severity Score; D007582:Jejunostomy / Q000379:methods; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
D002424:Caustics
balloon dilatation; bougie dilatation; caustic esophageal stricture; endoscopic therapy; esophageal stenting