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[Conservative treatment of benign esophageal strictures using dilation. Analysis of 500 cases]. / Tratamento conservador das estenoses benignas do esôfago através de dilatações. Análise de 500 casos.
Andreollo, N A; Lopes, L R; Inogutti, R; Brandalise, N A; Leonardi, L S.
Afiliação
  • Andreollo NA; Centro de Diagnóstico de Doenças Digestivas, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP. nandreollo@mailbr.com.br
Rev Assoc Med Bras (1992) ; 47(3): 236-43, 2001.
Article em Pt | MEDLINE | ID: mdl-11723504
UNLABELLED: The benign esophageal stenoses (BES) are common complications owing to many etiologies: gastroesophageal reflux, ingestion of corrosive agents, esophageal surgery, radiotherapy, postendoscopic variceal sclerotherapy, drug ingestion, prolonged nasogastric intubation, extrinsic compression and esophageal webs. Esophageal dilatations are worldwide recommended to treat this complication, employing dilators of many types and diameters and facilitating the food ingestion. PURPOSE: Evaluation of the results and advantages of the conservative treatment of the BES using esophageal dilatations, in outpatient service of upper digestive endoscopy. METHODS: During the period from 1981 to 1999, 500 patients with BES were treated and followed up at the Gastrocenter - UNICAMP, in an individually Program of Esophageal Dilatation for each case. The highest number of cases was under ages from 31 to 60 years old (52,8%), and males (59,2%). The most predominant etiologies were: peptic stenosis (30,4%), caustic ingestion (23,6%), anastomosis (23,2%), megaesophagus (8,0%) and prolonged nasogastric ingestion entubation (6,4%), totalizing 91,6% of the BES. Most of patients (94,2%) were submitted to the maximum of 25 dilations. Dilators from 10,5 to 16 mm were employed in 95,6% of the cases. The duration of the treatment was 24 months in 76,2% of the BES. Esophageal perforations occurred in 6 patients (1,2%), without mortality. RESULTS: Were considered excellent, good and bad results, respectively in 76,2%, 18,2% and 5,6% of the cases. On the other hand, excellent results were recorded in 81,0% of the peptic stenosis, 66,1% of the caustic stenosis and 82,7% of the anastomotic stenosis. The conservative treatment failed in 9,3% of the caustic stenosis, 4,3% of the anastomotic stenosis and 3,9% of the peptic stenosis. Thus, the caustic stenosis were unsuccessfull in the highest percentage of unsuccessful. CONCLUSION: The conservative treatment using guidewire dilators (Savary-Gilliard and Eder-Puestow) is the first choice in the BES, is effective for long time, with short complications and the surgical treatment is indicated only when the dilatations failed.
Assuntos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Esofagoscopia / Dilatação / Estenose Esofágica Tipo de estudo: Etiology_studies Limite: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: Pt Revista: Rev Assoc Med Bras (1992) Ano de publicação: 2001 Tipo de documento: Article País de publicação: Brasil
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Esofagoscopia / Dilatação / Estenose Esofágica Tipo de estudo: Etiology_studies Limite: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: Pt Revista: Rev Assoc Med Bras (1992) Ano de publicação: 2001 Tipo de documento: Article País de publicação: Brasil