Treatment of Esophageal Strictures with Savary-Guilliard Bougies

Abstract

Objective: Esophageal strictures may be caused by benign or malign disorders. Benign strictures are peptic stricture, Schatzki’s ring, esophageal web, and caustic ingestion, post-radiotherapy or post-surgical strictures. Dilatation with Savary-Guilliard bougies (SGD) is the most common endoscopic treatment of choice. In this study, we aimed to investigate the effectiveness of dilatation with Savary-Guilliard Bougies (SGB). Methods: We retrospectively analyzed the cases treated with SGD in Ankara Numune Education and Research Hospital between October 2005 and June 2011. All the demographic and clinical datas were recorded as well as endoscopic dilatation count and complications. Results: 73 patients (33(45.2%) males and 40 (54.8%) females) involved in the study. Mean age was 55,6±15,7(18-90) years old. A total of 536 dilatations of 73 patients performed in 169 sessions. Mean sessions of SGD 2,3±2.9(1-21) and dilatation counts were 7.4±9.4(1-65). The most seen etiologies were esophageal web (n=14, 19.2%), post-radiotherapy (n=14, 19.2%), anastomotic strictures (n=11, 15.1%) ingestion of corrosive substances (n=9, 12.3%) and malign strictures (n=8, 11%). The most seen benign causes and session counts were compared. Strictures secondary to radiotherapy and ingestion of caustic substances were the most common conditions treated with SGD. A single session was sufficient in strictures caused by esophageal web. No major complications such as perforation, major bleeding or sepsis were observed. Conclusion: SGD for the treatment of esophageal benign strictures is a safe, cheap, easily performed method without need for fluoroscopy. While treatment of esophageal web is usually treated with a single session, repeated endoscopic dilation sessions are required for the strictures caused by radiotherapy and corrosive ingestion.