Diagnostics and methods of endoscopic treatment of post-caustic esophageal strictures

Authors

  • A. V. Klymenko Zaporizhzhia State Medical University, Ukraine,
  • V. M. Klymenko Zaporizhzhia State Medical University, Ukraine,
  • O. M. Kiosov MI ERMC “University Clinic”, Zaporizhzhia State Medical University, Ukraine,
  • S. M. Gulevskiy MI ERMC “University Clinic”, Zaporizhzhia State Medical University, Ukraine,
  • V. V. Kechedzhyiev Zaporizhzhia State Medical University, Ukraine,

DOI:

https://doi.org/10.14739/2310-1210.2018.3.132113

Keywords:

esophageal stenosis, esophageal stricture, endoscopic balloon hydrodilatation, injection steroid drugs

Abstract

The article deals with stricture subsequent to esophageal corrosive injury and describes endoscopic treatment results and diagnostic methods. Etiologic and pathogenetic aspects of the esophageal corrosive injury development depending on damaging substance were reported and steroid endotherapy results considering modern classification were given. Clinical peculiarities of the disease were singled out according to endoscopic treatment results. Individual approaches to endoscopic and drug therapy in patients with caustic esophageal injury were covered depending on damaging substance and exposure time as well as postoperative follow-up of these patients.

The aim of the study was to evaluate the results of endoscopic treatment of post corrosive esophageal strictures using pneumatic balloon and hydro-balloon dilatation with subsequent glucocorticosteroid drug submucosal injection.

Material and methods. High-technology video endoscope system FUJINON EPX 4450 with HDTV imaging and digital chromoendoscopy Flexible spectral Imaging Color Enhancement (FICE) were used. Endoscopic examination included a detailed assessment of the esophageal mucosa condition (the presence of erosions, ulcers), centric or eccentric narrowing of the esophagus, the diameter of stricture determination, the possibility, feasibility and the staged manner of endoscopic treatment.

Result and discussion. All patients underwent pneumatic balloon and then hydro-balloon dilatation without the balloon removing, but only changing air and water supply. The synthetic hormone Flosteron (2 ml) was injected into the submucosal layers of the fracture sites after dilatation in order to inhibit and decrease fibroblasts formation, which reduced the risk of the esophagus mucous membrane severe scarring.

Conclusions: Endoscopic combined balloon dilatation in post corrosive esophageal strictures based on developed indications and technical aspects of performance is an effective and sufficiently safe method of treatment.

 

References

Godzhello, E. A., & Gallinger, Yu. I. (2007) Sovremenaya taktika i rezul'taty 20-letnego opyta e'ndoscopichescogo lecheniya rubcovykh stenosov pishchevoda [Current Tactics and Results of 20-years Experience of Endoskopic Treatment of Scar Esofageal Steanoses]. Viestnik khirurgicheskoj gastroe'nterologii, 1, 5–10. [in Russian].

Dzhafarov, Ch. M., & Dzhafarov, É. Ch. (2007) Khirurgicheskoe lechenie rubcovoj striktury pishchevoda i zheludka posle khimicheskogo ozhoga [Surgical treatment of cicatricial stricture of the esophagus and stomach after chemical burn]. Khirurgiya. Zhurnal im. N.I. Pirogova, 1, 25–28. [in Russian].

Klimashevich, A. V. (2014) Rezul'taty miniinvazivnogo lecheniya postozhogovykh rubcovykh striktur pishchevoda [The results of mini-invasive treatment of post-burncicatricial strictures of the esophagus]. Klinicheskaya i e'ksperimental'naya khirurgiya. Zhurnal im. akademika B.V. Petrovskogo, 3, 99–104. [in Russian].

Koroleva, M. P. (2009) Diagnostika i lechenie ozhogovykh suzhenij pishchevoda i zheludka [Diagnosis and treatment of burns of the esophagus and stomach]. Мoscow: Medicinskoe informacionnoe agentstvo. [in Russian].

Myaukina, L. М., & Filin, А. V. (2003) Algoritm diagnostiki i lecheniya bol'nykh posleozhogovymi rubcovymi suzheniyami pishchevoda [Algorithm for diagnosis and treatment of patients with post-burn cicatricial narrowing of the esophagus]. Abstracts of Papers of the 7th Moscow International Congress on Endoscopic Surgery. U.I. Gallingera (Ed), (S. 258–260). Мoscow. [in Russian].

Klimashevich, A. V., Nikolskiy, V. I., Nazarov, V. A., Bogonina, O. V., & Shabrov, A. V. (2013) Optimal'nyi sposob buzhirovaniya pishchevoda pri posleozhogovykh rubcovykh stricturakh [Optimal method of bougienage post-burn cicatricial esophageal strictures]. Fundamental'nye issledovaniya, 3, 88–91. [in Russian].

Sapegina, F. Z. (2005) Optimal'nye sroki ballonnoj dilatacii pri khimicheskom ozhoge pishchevoda (e'ksperimental'noe issledovanie) (Avtoref. dis…kand. med. nauk). [Optimum periods of balloon dilatation in case of chemical burn of the esophagus (experimental study)] (Extended abstract of candidate’s thesis). Мoscow. [in Russian].

Lew, R. J., & Kochman, M. L. (2002) A review of endoscopic methods of esophageal dilation. J ClinGastroenterol., 35, 117–126. doi: 10.1097/00004836-200208000-00001.

Robustelli, U., Bellotti, R. Scardi, F., Fortunato Armellino, M., De Masi, A., Forner, A. L., et al. (2011) Management of corrosive injuries of the upper gastrointestinal tract. Our experience in 58 patients. G. Chir., 32(4), 88–93.

Siersema, P. D., & de Wijkerslooth, L. R. (2009) Dilation of refractory benign esophageal strictures. Gastrointestinal endoscopy., 70(5), 1000–1012. doi: 10.1016/j.gie.2009.07.004.

Downloads

How to Cite

1.
Klymenko AV, Klymenko VM, Kiosov OM, Gulevskiy SM, Kechedzhyiev VV. Diagnostics and methods of endoscopic treatment of post-caustic esophageal strictures. Zaporozhye Medical Journal [Internet]. 2018May30 [cited 2024Nov.23];(3). Available from: http://zmj.zsmu.edu.ua/article/view/132113

Issue

No. 3 (2018)

Section

Case Reports

License

Authors who publish with this journal agree to the following terms:

    1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.  Лицензия Creative Commons
    2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
    3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)