Abstract
Background
Hydrostatic balloon dilatation of upper gastrointestinal strictures is associated with a risk of perforation that varies with the underlying pathology and with the technique employed. We present a technique of trans-balloon visualisation of the stricture during dilatation (TBVD) that allows direct ‘real-time’ observation of the effect of dilatation on the stricture, facilitating early recognition of mucosal abruption, thereby reducing the perforation rate.
Patients and Methods
We retrospectively analysed 100 consecutive patients, undergoing balloon dilatation of oesophageal strictures between 1st of January 2011 and 1st of July 2014.
Results
One hundred patients underwent 186 dilatations, with 34 having multiple procedures (mean 1.86). All had oesophageal strictures (mean diameter 8.49 mm, range 5–11 mm) and most underwent dilatation up to a maximum of 17 mm (mean 14.7 mm). Fifty-six percent were male and the average age was 62.5 years (17–89 years). Only one patient (0.5 % of all procedures) had a full-thickness perforation requiring intervention while just one further patient had a deep mucosal tear that did not require intervention.
Conclusions
TBVD is a safe technique with a short learning curve and is one of the important factors that allow potentially difficult dilatations to be performed safely with an exceptionally low rate of adverse events of less than 1 %.
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Acknowledgments
Dr. Asad Ali Toor, Dr. Hamid Majeed and Dr. Suhail Aslam Khan are acknowledged in this paper.
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Informed consent was obtained from all patients, and the study followed the guidelines stipulated by the institutional ethics committee.
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Khokhar, H.A., Azeem, B., Bughio, M. et al. Trans-Balloon Visualisation During Dilatation (TBVD) of Oesophageal Strictures: a Novel Innovation. J Gastrointest Surg 20, 674–679 (2016). https://doi.org/10.1007/s11605-015-3024-8
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DOI: https://doi.org/10.1007/s11605-015-3024-8