Corticosteroid injection of impassable caustic esophageal strictures without dilatation: Does it pave the way to interval endoscopic dilatation?
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In brief
In brief
This study demonstrates that four-quadrant corticosteroid injection of impassable caustic esophageal strictures enabled successful endoscopic dilatation in 75% of cases after two weeks, significantly reducing the need for major esophageal replacement surgery. The technique offers a minimally invasive bridge to definitive dilatation therapy in children with severe corrosive injuries.
Written by the GCMD Library team from the article.
Abstract
Background/Purpose
Endoscopic dilatation of caustic esophageal stricture is the mainstay of therapy. The need for esophageal replacement has decreased over the past decades owing to advancement in techniques of dilatation. In this study, we aimed to assess our results of four-quadrant corticosteroid injection of impassable caustic esophageal strictures followed by a trial endoscopic dilatation.
Methods
During the period from June 2003 to May 2017, in 340 patients in whom a trial of endoscopic dilatation after corrosive ingestion failed, corticosteroid was injected in 4 quadrants at the site of the stricture in the same setting. After 2 weeks, another trial of endoscopic dilatation was done.
Results
Out of the 340 patients with failed first trial of endoscopic dilatation followed by four-quadrant corticosteroid injection, the second trial of endoscopic dilatation, after 2 weeks, was possible in 255 patients (75%). In the remaining 85 patients (25%), the endoscope could not pass and they were candidate for esophageal replacement.
Conclusions
Four-quadrant corticosteroid injection of impassable caustic esophageal stricture followed by endoscopic dilatation is a minor procedure which decreased the need of a major procedure to replace the injured esophagus.
Type of the study
Clinical research paper.
Level of evidence
Level III.