Diagnostics and methods of endoscopic treatment of post-caustic esophageal strictures

The article deals with stricture subsequent to esophageal corrosive injury and describes endoscopic treatment results and diagnostic methods. Etiologic and pathogenetic aspects of the esophageal corrosive injury development depending on damaging substance were reported and steroid endotherapy results considering modern classification were given. Clinical peculiarities of the disease were singled out according to endoscopic treatment results. Individual approaches to endoscopic and drug therapy in patients with caustic esophageal injury were covered depending on damaging substance and exposure time as well as postoperative follow-up of these patients. The aim of the study was to evaluate the results of endoscopic treatment of post corrosive esophageal strictures using pneumatic balloon and hydro-balloon dilatation with subsequent glucocorticosteroid drug submucosal injection. Material and methods. High-technology video endoscope system FUJINON EPX 4450 with HDTV imaging and digital chromoendoscopy Flexible spectral Imaging Color Enhancement (FICE) were used. Endoscopic examination included a detailed assessment of the esophageal mucosa condition (the presence of erosions, ulcers), centric or eccentric narrowing of the esophagus, the diameter of stricture determination, the possibility, feasibility and the staged manner of endoscopic treatment. Result and discussion. All patients underwent pneumatic balloon and then hydro-balloon dilatation without the balloon removing, but only changing air and water supply. The synthetic hormone Flosteron (2 ml) was injected into the submucosal layers of the fracture sites after dilatation in order to inhibit and decrease fibroblasts formation, which reduced the risk of the esophagus mucous membrane severe scarring. Conclusions: Endoscopic combined balloon dilatation in post corrosive esophageal strictures based on developed indications and technical aspects of performance is an effective and sufficiently safe method of treatment.