OUTCOME OF ENDOSCOPIC THERAPEUTIC INTERVENTIONS: ARE THEY DIFFERENT AMONG VARIOUS NON- MALIGNANT ESOPHAGEAL DISEASES
AbstractBackground: This study was carried out to evaluate and compare the outcome of various causesof non-malignant lesions of the esophagus after endoscopic therapeutic intervention. Methods: Acohort of patients with non-malignant dysphagia presenting at Aga Khan University hospital, atertiary care setting who underwent endoscopic intervention was studied. Response to treatmentwas evaluated by improvement in dysphagia score on a scale of 0-4 and weight gain. Results: 99subjects (53 males) were included. Mean age was 48.6±17.2 years. Dysphagia for solids waspresent in 48%, for liquids in 3% and for both in 49% patients. Significant weight loss (>10%body weight) occurred in 35 (35.3%) patients. Achalasia was diagnosed in 49.5%, peptic stricturein 30.4%, post sclerotherapy stricture in 12.1%, corrosive injury in 4%, post-operative stricture in4%. In comparative analysis of achalasia and inflammatory groups, good response to dysphagiawas seen in 40/49 (82%) and 22/50 (44%) respectively p < 0.001. Weight gain was 35/49 (72%)and 22/50 (44%) p <0.001 respectively. Significantly, more endoscopic sessions were required ininflammatory group compare to achalasia; 2.2 and 1.1 respectively; p <0.001 and 16%complications rate in inflammatory group comparing to no complications in achalasia.Conclusions: Dysphagia and weight loss were common presentations in non-malignantesophageal diseases. Therapeutic intervention in inflammatory group was associated with highcomplication than the achalasia group.Key words: outcome of non-malignant esophageal diseases, Benign esophageal lesions,Achalasia, esophageal strictures.
Katz PO, Gilbert J, Castell DO. Pneumatic dilatation is
effective long- term treatment for achalasia. Dig Dis Sci 1998;
J Ayub Med Coll Abbottabad 2005;17(4)
Yeming W, Somme S, Chenren S, Huiming J, Ming Z.
Balloon catheter dilatation in children with congenital and
acquired esophageal anomalies. J Paeds Surg 2000;37(3)398-
Eckardt VF, Aignherr C, Bernhard G. Predictors of outcomes
in patients with achalasia treated by pneumatic dilatation.
Vantrappen G. Hellemans J, Deloof W, Valembois P,
Vandenbroucke J. Treatment of achalasia with pneumatic
dilations. Gut 1971;12:268-75.
Kim HC, Cameron AJ, Hsu JJ, Talley NJ, Trastek VF,
Pairolero PC et al. Achalasia: Prospective evaluation of
relationship between lower esophageal sphincter pressure,
esophageal transit and esophageal diameter and symptoms in
response to pneumatic dilatation. Mayo Clin Proc
Cocia G, Bortolotti M, Michetti P, Dodero M. Prospective
clinical and manometric study comparing pneumatic dilation
and sublingual nifedipine in the treatment of oesophageal
achalasia. Gut 1991;32:604-6.
Spiess AE, Kahrilas PJ. Treating Achalasia from whalebone to
laparoscope. JAMA 1998;280(7)638-42.
Sabharwal T, Cowling M, Dussek J, Owen W, Adam A.
Balloon Dilation for Achalasia of the Cardia: Experience in 76
patients Radiology 2002; 719-24.
Parkman HP, Reynolds JC, Ouyang A, Rosato EF, Eisenberg
JM, Cohen S. Pneumatic dilatation or esophagomyotomy
treatment for idiopathic achalasia: Clinical outcomes and cost
analysis. Dig Sci 1993;38:75-85.
Csendes A, Braghetto I, Henriquez A, Cortes C. Late results of
a prospective randomized study comparing forceful dilatation
and oesophagomyotomy in patients with achalasia. Gut
Abid S, Champion G, Richter JE, McElvein R, Slaughter RL,
Koehler RE. Treatment of achalasia: the best of both worlds.
Am J Gastroenterol 1994;89(7): 979-85.
Hussain SZ, Thomas R, Tolia V. A review of achalasia in 33
Children. Dig Dis Sci 2002;47(11)2538-43.
Reynold JC, Parkman HP. Achalasia. Gastroenterol clin North
London RL, Trotman BW, Di Marino AJ. Dilatation of severe
esophageal strictures by an inflatable balloon catheter.
Johnson A, Jensen LI, Mauritzen K. Balloon-dilation of
esophageal strictures in children. Pediatr Radiol 1986;16:388-
Braghetto I, Csendes A, Burdiles P, Korn O, Compan A,
Guerra JF. Barrett’s Esophagus Complicated with Stricture:
Correlation between Classification and the results of the
Different therapeutic Options. World J Surg 2002;26:1228-33.
Csendes A, Braghetto I. Peptic ulcer of the esophagus
secondary to reflux esophagitis. Gullet 1991;1:177-84.
Zaninotto G, DeMeester T, Bremner C. Esophageal function in
patients with reflux induced strictures and its relevance to
surgical treatment. Ann Thorac Surg 1989;47:362-70.
Barkum AN, Mayrand S. The treatment of peptic esophageal
stricture. Can J Gastroenterol 1997;11(Suppl B): 94-7
Bischof G, Feil W, Riegler M. Peptic esophageal stricture: is
surgery still necessary? Wien Klin Wochenschr 1996;108:267-
Agnew SR, Pandya SP, Reynolds RP. Predictors for frequent
esophageal dilatations of benign peptic strictures. Dig Dis Sci
; 41: 931-6
Song HY, Han YM, Kim HN, Kim CS, Choi KC. Corrosive
esophageal stricture safety and effectiveness of balloon
dilation. Radiology 1992;184:373-8.
Kim IO, Yeon KM, Kim WS, Park KW, Kim JH, Han MC.
Perforation complicating balloon dilation of esophageal
strictures in infants and children. Radiology 1993;189:741-4.
Pereira-Lima JC, Ramires RP, Zamin I, Cassal AP, Marroni
CA, Mattos AA. Endoscopic dilation of Benign Esophageal
Strictures: Report on 1043 Procedures. Am J Gastroenterol
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.