Effectiveness and Safety of Wire Guided Savary Dilatation in Corrosive Esophageal Stricture

Abstract

Background: Corrosive esophageal stricture is a type of esophageal stricture caused by the ingestion of corrosive substances, such as caustic soda or battery acid. This can cause injury to the lining of the esophagus, leading to scarring and narrowing of the esophagus. Treatment typically involves dilating the stricture using an endoscope, or surgery to remove the scar tissue. The conservative treatment of strictures generally seems to be effective and safe for relieving dysphagia both in the short and long term. Objective: To determine the mean number of dilatations of corrosive esophageal strictures to achieve adequate dilatation (up to 14mm). Study Design: Descriptive case series study. Settings: Department of Gastroenterology, Shalamar Hospital, Lahore Pakistan. Duration: 6 months, from February 2021 to July 2021. Methods: Esophageal dilatation was performed as an ambulatory procedure using conscious sedation and topical pharyngeal anesthesia. Dilatation was done under fluoroscopic guidance using Savary Gilliard dilators over the guide wire. All the outcomes were noted. The collected data was entered and analyzed on SPSS 21. Results: The mean age of the patients was 36.67±15.56 years, Male to female ratio of the patients was 1.4:1. 1-2 dilations was in 24(20%) patients, 2-3 dilations in 32 (26.7%), 3-4 in 32 (26.7%) and >4 dilation were in 32(26.7%) patients. A statistically insignificant difference was found between the adequate dilation with, age, gender, and marital status, i.e., (p= >0.05). Conclusion: Wire guided savary dilatation was observed to be the safe, effective and non-invasive technique. The successful adequate dilation for corrosive esophageal stricture achieved in 50.83% of the case. Although a significant proportion of patients (26.7%) required multiple dilations.