摘要
AIM: Endoscopic dilation of esophageal strictures is acommonly performed procedure in the management ofdysphagia. The procedure is usually done withfluoroscopic guidance. The aim of this study was toassess the use of Tracer guide wire in conjunction withSavary-Gilliard dilators in the dilation of tightesophageal strictures without fluoroscopy.METHODS: Fifty-five patients with significant dysphagiafrom strictures due to a variety of causes were dilatedendoscopically. The procedure consisted of two parts.First, a guidewire was passed using endoscopic guidance,and then, dilation was performed without fiuoroscopy.Amodified Tracer wire was employed and was particularlyeffective in negotiating very tight esophageal strictures,in which the lumen is less than 6 mm. In general, the'Rule of Three' and '2-3 sessions in 10 days, maximumdilation up to 42 French' rules were followed. 40:1dilations in a total of 55 patients(malignant strictures 30,benign 25) in 177 sessions were carried out.RESULTS: The guide wire placement and Savary-Gilliarddilation were successfully performed without fluoroscopy,and improvement of dysphagia was achieved in allpatients. Esophageal plastic stent (out diameter 40French) was placed in five patients with malignantstricture-three of them with tracheo-esophageal fistula.CONCLUSION: Dilation using Tracer guide wire withoutfluoroscopy is safe and effective in treatment of evenvery tight esophageal strictures.
AIM:Endoscopic dilation of esophageal strictures is a commonly performed procedure in the management of dysphagia.The procedure is usually done with fluoroscopic guidance.The aim of this study was to assess the use of Tracer guide wire in conjunction with Savary-Gilliard dilators in the dilation of tight esophageal strictures without fluoroscopy. METHODS:Fifty-five patients with significant dysphagia from strictures due to a variety of causes were dilated endoscopically.The procedure consisted of two parts. First,a guidewire was passed using endoscopic guidance, and then,dilation was performed without fluoroscopy.A modified Tracer wire was employed and was particularly effective in negotiating very tight esophageal strictures, in which the lumen is less than 6 mm.In general,the 'Rule of Three'and'2-3 sessions in 10 days,maximum dilation up to 42 French'rules were followed.401 dilations in a total of 55 paUents(malignant strictures 30, benign 25)in 177 sessions were carried out. RESULTS:The guide wire placement and Savary-Gilliard dilation were successfully performed without fluoroscopy, and improvement of dysphagia was achieved in all patients.Esophageal plastic stent(out diameter 40 French)was placed in five patients with malignant stricture-three of them with tracheo-esophageal fistula. CONCLUSION:Dilation using Tracer guide wire without fluoroscopy is safe and effective in treatment of even very tight esophageal strictures.
