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

Abstract

BACKGROUND:

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.

• Authors: R D Bapat, G D Bakhshi, C V Kantharia, S S Shirodkar, A P Iyer, S Ranka
• Journal: Indian 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
• PMID: 11676328 (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