The Treatment Effect of Savary Bougie Dilation in Benign Esophageal Strictures

Choi, Jeong Young; Kim, Jin Hong; Choi, Joon Hyuck; Lee, Kee Myung; Yoo, Byung Moo; Hahm, Ki Baik; Cho, Sung Won

Abstract

BACKGROUND/AIMS: Bougie dilatation is generally considered to be effective treatment of benign esophageal stricture. However, sometimes its therapeutic effect was unsatisfactory, or symptom used to recur after treatment. We reviewed our data to evaluate the efficacy of bougie dilation, and examined the factors associated with the bougienation effect.
METHODS
Fifty-five patients, who were diagnosed with a benign esophageal stricture, underwent bougie dilation, and were followed up for more than 6 months, and were retrospectively analyzed. The treatment effects were graded as 'cure', 'fair', 'poor', and 'no effect'. The factors which influenced the treatment effect were analyzed.
RESULTS
For the patients of severe pre-dilatation symptoms, long stricture lesion, and severe endoscopic stricture, the therapeutic effect of bougienation was significantly bad (p=0.002, 0.001, 0.019). Therapeutic effect was higher in patients who were treated with large diameter dilator in the first session (p=0.005), and has stronger relation with the length of stricture than the degree of stricture. In the follow-up period, 45 (81.8%) of 56 patients has achieved cure response. In the cure response group, 30 patients (66.7%) needed one, 5 (11.1%) needed two, 5 (11.1%) needed three, 3 (6.7%) needed four, 1 (2.2%) needed five, and the last one (2.2%) needed six sessions of bougienation.
CONCLUSIONS
The luminal diameter of the stricture, the length of the stricture and the diameter of the dilator used in the initial session were associated with treatment effect. Bougie dilatation was reconfirmed to be effective treatment modality for benign esophageal stricture.