Abstract
Background
The multidiameter balloon catheter is used widely for severe esophageal stricture dilation. However, the relationships between inflation pressure, balloon size, and radial dilation force at the stricture site have not been examined fully.
Methods
We performed an experiment using phantom models to investigate the relationships between inflation pressure, balloon size, and radial dilation force. The balloon dilation procedure was performed for each stricture model using three sizes of balloon: 10–11–12, 12–13.5–15, and 15–16.5–18 mm.
Results
A positive association between inflation pressure and dilation force was observed for each balloon size. In balloons inflated by targeting the same diameter, the dilation force was higher for smaller balloons than for larger balloons. An inverse association between stricture size and dilation force was observed in the 12–13.5–15 mm balloon (3 vs 5 mm, P = .002; 5 vs 7 mm, P < .001).
Conclusions
We found relationships between inflation pressure, balloon size, severity of strictures, and dilation force. To perform safe and effective esophageal balloon dilation, the inflation pressure and balloon size should be selected after considering the stricture size and target diameter.
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References
de Wijkerslooth LRH, Vleggaar FP, Siersema PD (2011) Endoscopic management of difficult or recurrent esophageal strictures. Am J Gastroenterol 106:2080–2091
Spechler SJ (1999) American gastroenterological association medical position statement on treatment of patients with dysphagia caused by benign disorders of the distal esophagus. Gastroenterology 117:229–233
Siersema PD (2008) Treatment options for esophageal strictures. Nat Clin Pract Gastroenterol Hepatol 5:142–152
Siersema PD, de Wijkerslooth LRH (2009) Dilation of refractory benign esophageal strictures. Gastrointest Endosc 70:1000–1012
Egan JV, Baron TH, Adler DG, Davila R, Faigel DO, Gan S, Hirota WK, Leighton JA, Lichtenstein D, Qureshi WA, Rajan E, Shen B, Zuckerman MJ, VanGuilder T, Fanelli RD (2006) Esophageal dilation. Gastrointest Endosc 63:755–760
Riley SA, Attwood SEA (2004) Guidelines on the use of oesophageal dilatation in clinical practice. Gut 53(Suppl 1):i1–i6
Goldstein J, Barkin JSA (2000) Comparison of the diameter consistency and dilating force of the controlled radial expansion balloon catheter to the conventional balloon dilators. Am J Gastroenterol 95:3423–3427
Purushothama Raj P, Ramasamy V (2012) Strength of materials (Kindle Edition), 1st edn. Pearson, Upper Saddle River
Acknowledgments
This research was partially supported by a grant from the Practical Research for Innovative Cancer Control from the Japan Agency for Medical Research and Development.
Author contributions
H.H. and M.M. contributed to conception and design. Y.N., O.K., S.N., and M.N. analyzed the data. All authors interpreted data for the work. Y.N., H.H., O.K., M.K., S.N., and M.M. drafted the work. A.Y., Y.E., I.A., M.N., T.H., and M.M. critically revised the work for important intellectual content.
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Yoshitaka Nishikawa, Hirokazu Higuchi, Osamu Kikuchi, Yasumasa Ezoe, Ikuo Aoyama, Atsushi Yamada, Masataka Kanki, Shuhei Nomura, Motoo Nomura, Takahiro Horimatsu, and Manabu Muto have no conflicts of interest or financial ties to disclose.
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Nishikawa, Y., Higuchi, H., Kikuchi, O. et al. Factors affecting dilation force in balloon dilation of severe esophageal strictures: an experiment using an artificial stricture model. Surg Endosc 30, 4315–4320 (2016). https://doi.org/10.1007/s00464-016-4749-5
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DOI: https://doi.org/10.1007/s00464-016-4749-5