BOUGIE DILATATION IN BENIGN ESOPHAGEAL STRICTURES: EVALUATION OF ADJUVANT METHYLPREDNISOLONE INJECTION

Abstract

Objective: Mechanical dilatation and adjuvant injection of triamcinolone acetate (TA) effectively preserve the opening provided and reduce the number of bougie dilation (BD) in benign esophageal strictures. In this study, we aimed to evaluate the role of Methylprednisolone (MP) injection after BD in providing permanent/long-term lumen opening. Materials and Methods: Among 22 patients diagnosed with benign esophageal strictures (BES) between January 2017 and October 2020, we evaluated the results of 8 patients who continued the endoscopic follow-up program and underwent BD and MP injection, then compared with the literature. Results: We treated 8 patients [6 (75%) women, mean age 61±16.9 years (range 22-77)] with strictures of different etiologies (3 anastomotic, 2 iatrogenic esophageal rupture repairs, 2 recurrent webs, and 1 scleroderma) with BD followed by intralesional MP injection. We performed median BD sessions 3.5 times (range 1-8). We gave a median 3 intralesional MP injection (range 1-7). The median time to resolve stricture was 2.5 months (range 1-4). The median endoscopic follow-up time was 4.5 months (range 1-17). Conclusions: Adjuvant MP injection is successful in preserving the lumen patency provided after mechanical dilatation. Randomized controlled studies are needed to determine the steroid type and dose to provide the most optimal permanent lumen opening with lesser dilatation sessions in BES.