Clinical Research
Copyright ©The Author(s) 2002. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 15, 2002; 8(4): 766-768
Published online Aug 15, 2002. doi: 10.3748/wjg.v8.i4.766
Endoscopic dilation of esophageal stricture without fluoroscopy is safe and effective
Yong-Guang Wang, Thian-Lok Tio, Nib Soehendra
Yong-Guang Wang, Department of Endoscopic Surgery, Peking University People's Hospital, 100034 Beijing, China
Thian-Lok Tio, Division of GI, Department of Medicine, Georgetown University Hospital, Washington DC, USA
Nib Soehendra, Department of Interdisciplinary Endoscopy, University Hospital Eppendorf, Hamburg, Germany
Author contributions: All authors contributed equally to the work.
Correspondence to: Yong-Guang Wang MD, PhD, Department of Endoscopic Surgery, Peking University People's Hospital, Beijing 100034, China.
Telephone: +86-10-66510952 Fax: +86-10-66510952
Received: September 21, 2000
Revised: September 25, 2000
Accepted: September 29, 2000
Published online: August 15, 2002

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 d, maximum dilation up to 42 French" rules were followed. 401 dilations in a total of 55 patients (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.

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