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Self-bougienage: long-term relief of corrosive esophageal strictures.

AbstractBACKGROUND:
Corrosive esophageal strictures require dilatation at frequent intervals.
OBJECTIVE:
To determine the efficacy of self-dilatation in treatment of corrosive esophageal strictures.
METHODS:
Retrospective analysis of data from 51 patients with corrosive esophageal strictures seen in a surgical unit. Eighteen patients underwent per-oral antegrade dilatation of stricture using gum elastic bougies (Group I); 15 patients underwent retrograde dilatation with endless string using an India rubber dilator devised at the authors' institution, followed by per-oral antegrade dilatation (Group II); 15 patients underwent retrograde dilatation followed by antegrade dilatation with endless string through esophagostomy (Group III). In three patients with stricture of the entire esophagus, endless string could not be passed; they were subjected to esophagocoloplasty. All patients were taught self-dilatation with gum elastic bougies as the final step, and were put on a progressive, domiciliary, self-dilatation program. Quarterly follow up was done for one year, to ascertain whether self-bougienage was being performed properly.
RESULTS:
All patients responded well to treatment, with significant relief of dysphagia and improvement in health and barium study findings. Six patients developed mediastinitis (3, 2 and 1 in Groups I, II and III, respectively) during initial dilatation; all improved with conservative management. Only one patient who failed to carry out self-bougienage had to be readmitted and retrained in the procedure, after which he remained asymptomatic.
CONCLUSIONS:
Patients with corrosive esophageal strictures can be treated with a long-term self-bougienage program, which avoids the need for frequent hospital admissions for esophageal dilatation.
AuthorsR D Bapat, G D Bakhshi, C V Kantharia, S S Shirodkar, A P Iyer, S Ranka
JournalIndian journal of gastroenterology : official journal of the Indian Society of Gastroenterology (Indian J Gastroenterol) 2001 Sep-Oct Vol. 20 Issue 5 Pg. 180-2 ISSN: 0254-8860 [Print] India
PMID11676328 (Publication Type: Journal Article)
Topics
  • Adolescent
  • Adult
  • Burns, Chemical (complications)
  • Dilatation (methods)
  • Esophageal Stenosis (chemically induced, therapy)
  • Esophagostomy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Self Care
  • Treatment Outcome

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