RESUMO
The subjects of the study were 221 patients with cicatrical esophageal strictures. 62 (28.5%) patients had peptic strictures, and 159 (71.9%)--post-burn strictures. 67 (30.3%) patients underwent esophageal resection with one-stage intrapleural esophagoplasty with the stomach, 152 (68.8%) patients--gullet bougienage in combination with surgical intervention or as an only treatment. The study revealed 8 cases of squamous cell carcinoma in patients with post-burn strictures, and 3 cases of squamous cell carcinoma in patients with peptic strictures. In 2 cases the researchers found early stage of esophageal cancer (verrucose carcinoma)--in 1 patient with post-burn stricture and 1 patient with peptic stricture. The results suggest an important role of chronic gastroesophageal reflux in the oncogenesis of esophageal squamous cell carcinoma in patients with post-burn and peptic strictures.
Assuntos
Queimaduras Químicas/complicações , Neoplasias Esofágicas/etiologia , Estenose Esofágica/complicações , Esofagite Péptica/complicações , Esôfago/lesões , Refluxo Gastroesofágico/complicações , Adulto , Biópsia , Queimaduras Químicas/patologia , Carcinoma Verrucoso/etiologia , Carcinoma Verrucoso/patologia , Doença Crônica , Cicatriz , Progressão da Doença , Neoplasias Esofágicas/patologia , Estenose Esofágica/patologia , Esofagite Péptica/patologia , Feminino , Refluxo Gastroesofágico/patologia , Humanos , Masculino , Estudos RetrospectivosRESUMO
The purpose of the research was to study the efficacy of the bougienage of after-burn esophageal strictures against the background of long-term treatment with proton pump inhibitors of H2-blockers. 100 patients with after-burn esophageal strictures were divided into 3 groups in a random way: 1) only bougienage--53 patients; 2) bougienage and omeprazole, 20 mg per day during 12 months--20 patients; 3) bougienage and ranitidine, 300 mg per day during 12 months--27 patients. Bougienage was efficient in 83 patients (83%). 17 patients underwent esophagoplasty due to inefficiency of bougienage. Repeated bougienage was necessary for 35% of patients who were taking omeprazole (p = 0.04), 48.1%--ranitidine (p = 0.2), and 60.4% of patients who underwent only bougienage. Bougienage of the esophagus is efficient in treatment of after-burn strictures. Twelve-month treatment of these patients with omeprazole reduces the number of repeated bougienage courses significantly.