Predictive Factors of Endoscopic Dilation Failure of Benign Esophageal Stenosis

Aims The aim of our study was to determine the limits of Endoscopic dilatation (ED) in esophageal Benign Stenosis (BS).

Methods This is a retrospective study including all patients who have had one or more sessions of ED of esophageal BS (by hydrostatic balloon or Savary candles) in our endoscopy unit over a period of 8 years [2011 - 2019]). Patients were divided into 3 groups:Group A patients with dysphagia regression, Group B late recurrence (after one year) of dysphagia and Group C persistent dysphagia after a dilation series or early recurrence. ED failure was defined by Groupe C.

Results Forty-five patients were included in our study. The mean age was 55.31 years [18.97 years]. The sex ratio (M/F) was 0.8. The most common types of stenosis were peptic stenosis in 42 % of cases, Plummer Vincent syndrome in 33 % and caustic stenosis in 13 % of cases.The average number of dilation sessions was 2.5 [1.6]. The mean interval between sessions was 3 weeks. No complications (perforation) were noted in our series. Twenty-eight patients responded well to the dilation series and remained asymptomatic after a 5-year follow-up (Group A).Nine patients had a late recurrence within the first 5 years (mean time to recurrence = 3 years) (Group B). Eight patients remained symptomatic of dysphagia after the first dilation series (Group C). Factors predictive of late recurrence were: number of initial dilation sessions ≥3 (P = 0.003), extent of stenosis > 2cm (P = 0.05) and caustic stenosis (P = 0.04). Predictors of failure were: undernutrition (P = 0.03), tight stenosis (<6cm: P = 0.001), and location of stenosis in the upper 1/3 of the esophagus (P = 0.05).

Conclusions In our study, factors predictive of dilation failure were mainly related to the characteristics of the stenosis (location and tightness) and the impact on nutritional status. In this cases,another therapeutic alternative (corticosteroid injection, stents, surgery) should be considered.

Citation: Ben Farhat F, Sabbah M, Bellil N et al. eP57 PREDICTIVE FACTORS OF ENDOSCOPIC DILATION FAILURE OF BENIGN ESOPHAGEAL STENOSIS. Endoscopy 2021; 53: S115.

Publication History

Article published online:
19 March 2021