透视下球囊扩张治疗良性放射性食管狭窄

Fluoroscopically Guided Balloon Dilation for benign esophageal Stricture after Radiation Therapy

目的评估透视下球囊扩张治疗良性放射性食管狭窄的安全性和长期疗效。方法从1997年6月至2008年12月,我科共对12例良性放射性食管狭窄行透视下球囊扩张治疗。最大球囊直径为15mm(n=19),20mm(n=5),25mm(n=2)。对此治疗的技术成功率、临床成功率、吞咽困难复发和并发症分别进行评估。结果12例患者共接受了26次球囊扩张(平均2.2次),技术成功率为100%,临床成功率为75%,5例患者仅行1次扩张。7例患者在首次扩张后出现复发,随后进行了重复扩张。1例患者出现Ⅰ型食管穿孔,无严重并发症出现。结论尽管球囊扩张的复发率高,透视下球囊扩张仍然是简单、安全治疗良性放射性食管狭窄首选方法。

Obiectvie To assess the safety and long term efficacy of fluoroscopically guided balloon dilation for benign esophageal strictures after radiation therapy. Materials and methods From June 1997 to December 2008, fluoroscopically guided balloon dilation was performed in 12 patients with benign esophageal strictures caused by RT. The maximum balloon diameters were 15 mm （n=19）, 20 mm （n=5）, 25 mm （n=2）.Technical success, clinical success, recurrence of dysphagia and complications related to the procedure were retrospectively evaluated. Results All i2 patients underwent 26 balloon dilation procedures with each patient undergoing one to four procedures （mean, 2.2）. Technical success rate was 100% and clinical success was achieved in 75% （9/12） of all the patients. Five patients （41.7%） showed no recurrence of dysphagia after one session of balloon dilation. Seven patients （58.4%） showed recurrence of dysphagia and underwent repeat balloon dilation. As minor complication, type 1 esophageal rupture occurred in one patient （8.3%）. There were no major complications. Conclusion Although the recurrence with repeat balloon dilation rate is high, fluoroscopically guided balloon dilation seems to be a simple and safe primary treatment modality for benign esophageal stricture due to radiation therapy.