Esophageal stent placement versus endoscopic incision for the treatment of refractory esophageal anastomotic stricture / 医学研究生学报

Objective Few reports are seen comparing esophageal stent placement (ESP) and the endoscopic incision method (EIM) in the treatment refractory esophageal anastomotic strictures (EAS) following esophageal carcinoma resection (ECR). This study was to evaluate the effect ESP versus that of EIM in the treatment of refractory EAS after ECR. Methods We retrospectively analyzed the clinical data on 50 cases of post-ECR refractory EAS treated by ESP (n = 32) or EIM (n = 18) in our Center of Digestive Medicine between January 2012 and December 2018. We recorded and compared the pre- and post-operative dysphagia scores, post-operative complications and follow-up results between the two groups of patients. Results Compared with the EIM group, the patients of the ESP group had a remarkably lower dysphagia score post-operatively (1.4±0.5 vs 1.0±0.0, P<0.01), a smaller diameter of the dilated esophagus ([19.9±1.8] vs [11.0±1.9] mm, P<0.01), higher incidence rates mild and severe chest pain (P=0.022), and a higher rate of relief of esophageal stricture at 12 months after surgery (P<0.05). Conclusion EIM can rapidly relieve the symptoms of esophageal anastomotic stricture, while ESP may achieve a longer duration of relief. Both of the procedures are safe for patients with refractory esophageal anastomotic stricture.

Research progress in endoscopic incision in treating gastrointestinal benign stricture / 中南大学学报(医学版)

Gastrointestinal benign stricture is a common disease with symptoms of dysphagia,abdominal pain and difficult defecation,which severely impair the quality of life for patients.Endoscopic intervention is the first-line treatment,and the available methods include balloon dilation,local drug injection and stent insertion,etc.Endoscopic incision was first used for the treatment of Schatzki's rings,and later it was used for the treatment of other gastrointestinal benign strictures,and the promising results were achieved.

A Rare Coincidence of Esophageal Intramural Pseudodiverticulosis with Esophageal Web

We report a rare case of esophageal intramural pseudodiverticulosis (EIPD) associated with esophageal web in a 67-year-old man presenting with dysphagia. EIPD is characterized by multiple tiny flask-shaped outpouchings of the mucosa that extend into the muscular layer on esophagography. EIPD commonly presents with stricture and less commonly with esophageal web. Although etiologies of both EIPD and esophageal web are unclear, a chronic inflammatory condition has been proposed. Treatment of EIPD is usually directed at the associated conditions rather than at the pseudodiverticulosis itself. In our case, dysphagial was successfully relieved by endoscopic dilatation with incision methods for the esophageal web.

Transurethral Incision for Ureterocele / 대한비뇨기과학회지

PURPOSE: A transurethral incision of the ureterocele offers several advantages. This study investigated the clinical efficacy of a transurethral incision in a ureterocele. MATERIALS AND METHODS: Twenty two children, 5 boys and 17 girls, received a transurethral incision as the primary treatment for their ureteroceles. Of the children, 12 had intravesical and 10 had ectopic ureteroceles. The initial presentations were abnormal findings in prenatal ultrasonography in 9 cases, fever in 7, UTI in 2, and others in 4. The median patient's age at the transurethral incision of the ureterocele was 3.3 months (range 0.2month to 4.1years). A cold knife or a 3-french Bugbee electrode was used. Their clinical courses were evaluated with a radiological and laboratory examinations. RESULTS: The transurethral incision resulted in the decompression of the ureterocele in 19 (86%), reflux to the upper moiety in 15 (68%), UTI in 2 (9%) and incontinence in 1 (4.5%). Eighteen patients (82%), 8 patients with an intravesical ureterocele and all 10 patients with an ectopic ureterocele, required secondary operations. A transurethral incision proved to be a definitive treatment for 4 (33.3%) patients with an intravesical ureterocele. Secondary operations were performed at 7.3 7.1months postoperatively. CONCLUSIONS: An endoscopic incision may be advocated as a definitive treatment modality for some patients with an intravesical ureterocele. Furthermore, by safely delaying reconstructive surgery, the majority of children can benefit from an endoscopic incision of the ureterocele.

Clinical Usefulness of Combination Therapy with Endoscopic Incision Using Needle-Knife Papillotome and Local Injection of Steroid for the Treatment of Benign Esophageal Anastomotic Stricture / 대한소화기내시경학회지

BACKGROUND/AIMS: The endoscopic incision for the treatment of benign esophageal anastomotic stricture (BEAS) was uncommonly reported because of the frequent recurrence of stricture. Intralesional steroid injection has been shown to be effective in prevention of recurrence, so we have performed the combination therapy with endoscopic incision and intralesional steroid injection. METHODS: Fourteen patients with BEAS were treated with endoscopic radial cuts using needle-knife papillotome together with intralesional injection of triamcinolone. The mean age of the 14 patients was 58.1 and mean follow-up days was 205.8 (65~439). RESULTS: The onset of BEAS were 135.6+/-73.0 days and significantly early in patients with distorted stapling (p=0.012). After treatment the diameter of stricture was significantly increased (p=0.001) and the dysphagia was improved above 2 degrees. Initial dilatation was successfully done in one session and there was 10 cases of mild bleeding. The stricture recurrence was developed in 4 cases (30.7%), which showed tendency in long length of stricture (p=0.12) and significance in distorted stapling (p=0.007). CONCLUSIONS: The combination therapy with endoscopic incision and steroid injection may be useful method for the treatment of BEAS, but further long-term follow-up and comparative study were needed.

Endoscopic Incision Therapy by Needle Knife Papillotome in the Treatment of Postoperative Anastomotic Stenosis / 대한소화기내시경학회지

Endoscopic incision therapy was applied to two patients with postoperative anast-omotic stenosis. Radial diathermy incision was performed by needle knife papillot-ome using cutting current. Tne anastomotic stenosis was characteristic of short fibrotic segment and frequent restenosis after dilatation. An sufficient caliber and smooth, supple wall at the site of the stenosis was produced by incisional therapy by needle knife papillotome using cutting current. Clinical symptoms and endoscopic findings were improved after endoscopic incision. It is concluded that endoscopic incisional therapy seems to be safe and effective method for the treatment of anastomotic stenosis after gastrointestinal operation.

Endoscopic Incision Therapy by Needle Knife Papillotome in the Treatment of Postoperative Anastomotic Stenosis / 대한소화기내시경학회지

Endoscopic incision therapy was applied to two patients with postoperative anast-omotic stenosis. Radial diathermy incision was performed by needle knife papillot-ome using cutting current. Tne anastomotic stenosis was characteristic of short fibrotic segment and frequent restenosis after dilatation. An sufficient caliber and smooth, supple wall at the site of the stenosis was produced by incisional therapy by needle knife papillotome using cutting current. Clinical symptoms and endoscopic findings were improved after endoscopic incision. It is concluded that endoscopic incisional therapy seems to be safe and effective method for the treatment of anastomotic stenosis after gastrointestinal operation.