[Endoscopic treatment of benign esophageal stenosis]. / Il trattamento endoscopico delle stenosi esofagee benigne.

Benign esophageal stenosis is the most frequent type of stenosis of the digestive tract. Surgical treatment is still affected by a high percentage of morbidity and mortality. This is not acceptable for a condition which is not neoplastic in nature. The introduction of modern endoscopic instruments has significantly simplified the technique also reducing the complications, therefore oesophageal dilatation has a fundamental role. The main indications to endoscopic treatment are represented by postoperative stenosis, and those caused by caustics, peptic acid, actinic lesions and achalasia. During the past 15 years, the Authors performed 205 endoscopic dilatation including 26 cases affected by esophageal achalasia. In the experience of the Authors, olivarian metallic probes were gradually abandoned in favour of Celestin & Savary polimetric dilators while pneumatic dilators were preferred only in achalasic cases. Endoscopic therapy was resolutive in 24 patients affected by achalasia (92.3%). In 158 patients, mechanic dilatation was employed (88.2%) and among them, 4 cases (2.19%) of esophageal perforation were observed. Overall, mortality rate was zero. As far as the average number of dilatation employed, the highest number was registered among caustic lesions (5), followed by peptic (4), and post-operative stenosis (1). The results obtained confirm the validity and efficacy of the endoscopic treatment for benign esophageal stenosis also considering the good compliance of the patients and the fact that no general anaesthesia is required.

[Endoscopic ligation and sclerotherapy in the treatment of esophageal varices]. / La legatura endoscopica e la scleroterapia nel trattamento delle varici esofagee.

Endoscopic variceal ligation (EVL) and esophageal variceal sclerotherapy (EVS) are both used in the treatment of esophageal varices. Sclerotherapy is widely used with success, however it is associated with multiple local and systemic complications. To overwhelm the complications of sclerosis, Stiegmann in 1986 proposed the elastic band variceal ligation which demonstrated to be efficient as sclerotherapy though with minor side effects. Therefore, the Authors decided to apply a therapeutical protocol with EVL for the primary prevention of variceal esophageal bleeding. Preliminary results are herein reported.