title: Trans-Balloon Visualisation During Dilatation (TBVD) of Oesophageal Strictures: a Novel Innovation.
abstract: BACKGROUND
  Hydrostatic balloon dilatation of upper gastrointestinal strictures is associated with a risk of perforation that varies with the underlying pathology and with the technique employed. We present a technique of trans-balloon visualisation of the stricture during dilatation (TBVD) that allows direct 'real-time' observation of the effect of dilatation on the stricture, facilitating early recognition of mucosal abruption, thereby reducing the perforation rate.
  
  
  METHODS
  We retrospectively analysed 100 consecutive patients, undergoing balloon dilatation of oesophageal strictures between 1st of January 2011 and 1st of July 2014.
  
  
  RESULTS
  One hundred patients underwent 186 dilatations, with 34 having multiple procedures (mean 1.86). All had oesophageal strictures (mean diameter 8.49 mm, range 5-11 mm) and most underwent dilatation up to a maximum of 17 mm (mean 14.7 mm). Fifty-six percent were male and the average age was 62.5 years (17-89 years). Only one patient (0.5% of all procedures) had a full-thickness perforation requiring intervention while just one further patient had a deep mucosal tear that did not require intervention.
  
  
  CONCLUSIONS
  TBVD is a safe technique with a short learning curve and is one of the important factors that allow potentially difficult dilatations to be performed safely with an exceptionally low rate of adverse events of less than 1%.
authors.affiliation: Upper GI Surgical Department, Connolly Hospital Blanchardstown, Dublin 15, Ireland. drheebeez@gmail.com.|, 9 The Avenue, Highfield Park, Ballincollig, County Cork, Ireland. drheebeez@gmail.com.
authors.forename: Haseeb A
authors.initials: HA
authors.lastname: Khokhar
authors.affiliation: Upper GI Surgical Department, Connolly Hospital Blanchardstown, Dublin 15, Ireland.
authors.forename: Beenish
authors.initials: B
authors.lastname: Azeem
authors.affiliation: Upper GI Surgical Department, Connolly Hospital Blanchardstown, Dublin 15, Ireland.
authors.forename: Mumtaz
authors.initials: M
authors.lastname: Bughio
authors.affiliation: Upper GI Surgical Department, Connolly Hospital Blanchardstown, Dublin 15, Ireland.
authors.forename: Gary A
authors.initials: GA
authors.lastname: Bass
authors.affiliation: Upper GI Surgical Department, Connolly Hospital Blanchardstown, Dublin 15, Ireland.
authors.forename: Amr
authors.initials: A
authors.lastname: Elfadul
authors.affiliation: Upper GI Surgical Department, Connolly Hospital Blanchardstown, Dublin 15, Ireland.
authors.forename: Monim
authors.initials: M
authors.lastname: Salih
authors.affiliation: Upper GI Surgical Department, Connolly Hospital Blanchardstown, Dublin 15, Ireland.
authors.forename: Waleed
authors.initials: W
authors.lastname: Fahmy
authors.affiliation: Upper GI Surgical Department, Connolly Hospital Blanchardstown, Dublin 15, Ireland.
authors.forename: Thomas N
authors.initials: TN
authors.lastname: Walsh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002404:Catheterization / Q000009:adverse effects; D004106:Dilatation / Q000009:adverse effects; D004939:Esophageal Perforation / Q000209:etiology / Q000517:prevention & control*; D004940:Esophageal Stenosis / Q000628:therapy*; D004945:Esophagoscopy / Q000009:adverse effects / Q000379:methods*; D004947:Esophagus / Q000293:injuries; D005260:Female; D006801:Humans; D022125:Lacerations / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000293:injuries; D012189:Retrospective Studies; D055815:Young Adult
keywords: Dilatation; Perforation; Strictures