Esophageal dilation can be done safely using selective fluoroscopy and single dilating sessions. | Read by QxMD (original) (raw)
R A Kozarek, D J Patterson, T J Ball, M G Gelfand, G E Jiranek, J E Bredfeldt, J J Brandabur, H W Wolfsen, S L Raltz
Maxims for safe esophageal dilation have included recommendations to use fluoroscopy in all instances and to limit dilation sessions to 2-mm increments. We reviewed a 34-month experience of all esophageal dilations undertaken at a large multispecialty clinic to define adherence to these recommendations and to delineate whether deviation was associated with significant complications. Four hundred thirty-two patients underwent 716 courses of esophageal dilation during this time, 92% of whom had benign disease. Eighty-nine percent of patients were dilated with polyvinyl dilators (Savary/American) and only 8% of these patients required fluoroscopic monitoring for the bougienage. Seventy-eight percent of the dilating sessions for patients without achalasia were undertaken using either a single large dilator (> or = 45 Fr) or employed incremental dilator sizes > 2 mm (6 Fr) in a single session. There was a single perforation in 662 nonachalasia dilations and this was a consequence of attempted placement of an esophageal endoprosthesis. We conclude that use of guide wire technology and newer dilating techniques do away with the need for routine fluoroscopic control. Moreover, single large dilators or dilator increments > 2 mm may be safely used, contingent on endoscopic stricture assessment.
Full text links
We have located links that may give you full text access.
Related Resources
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-
2024
by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our
and
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app