Esophageal stricture surgery: Difference between revisions

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Surgery is the mainstay of treatment for [disease or malignancy].
Surgery is the mainstay of treatment for [disease or malignancy].
==Surgery==
==Surgery==
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The most common cause of esophageal stricture is gastroesophageal reflux disease. Treatment for esophageal stricture is combination of dilation and  proton pump inhibitors  or H2 antagonist therapy.<ref name="pmid7926495">{{cite journal |vauthors=Smith PM, Kerr GD, Cockel R, Ross BA, Bate CM, Brown P, Dronfield MW, Green JR, Hislop WS, Theodossi A |title=A comparison of omeprazole and ranitidine in the prevention of recurrence of benign esophageal stricture. Restore Investigator Group |journal=Gastroenterology |volume=107 |issue=5 |pages=1312–8 |year=1994 |pmid=7926495 |doi= |url=}}</ref>
The most common cause of esophageal stricture is gastroesophageal reflux disease. Treatment for esophageal stricture is combination of dilation and  proton pump inhibitors  or H2 antagonist therapy.<ref name="pmid7926495">{{cite journal |vauthors=Smith PM, Kerr GD, Cockel R, Ross BA, Bate CM, Brown P, Dronfield MW, Green JR, Hislop WS, Theodossi A |title=A comparison of omeprazole and ranitidine in the prevention of recurrence of benign esophageal stricture. Restore Investigator Group |journal=Gastroenterology |volume=107 |issue=5 |pages=1312–8 |year=1994 |pmid=7926495 |doi= |url=}}</ref>
* Cautious dilation <ref name="pmid15625037">{{cite journal |vauthors=Nostrant TT |title=Esophageal Dilation / Dilators |journal=Curr Treat Options Gastroenterol |volume=8 |issue=1 |pages=85–95 |year=2005 |pmid=15625037 |doi= |url=}}</ref>
* Cautious dilation <ref name="pmid15625037">{{cite journal |vauthors=Nostrant TT |title=Esophageal Dilation / Dilators |journal=Curr Treat Options Gastroenterol |volume=8 |issue=1 |pages=85–95 |year=2005 |pmid=15625037 |doi= |url=}}</ref>
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** Bleeding disorders
** Bleeding disorders
** Severe cardiovascular disease or pulmonary disease
** Severe cardiovascular disease or pulmonary disease
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* Dilators<ref name="pmid15625037" />  <ref name="pmid2382455">{{cite journal |vauthors=Shemesh E, Czerniak A |title=Comparison between Savary-Gilliard and balloon dilatation of benign esophageal strictures |journal=World J Surg |volume=14 |issue=4 |pages=518–21; discussion 521–2 |year=1990 |pmid=2382455 |doi= |url=}}</ref><ref name="pmid7818628">{{cite journal |vauthors=Cox JG, Winter RK, Maslin SC, Dakkak M, Jones R, Buckton GK, Hoare RC, Dyet JF, Bennett JR |title=Balloon or bougie for dilatation of benign esophageal stricture? |journal=Dig. Dis. Sci. |volume=39 |issue=4 |pages=776–81 |year=1994 |pmid=7818628 |doi= |url=}}</ref>       
* Dilators<ref name="pmid15625037" />  <ref name="pmid2382455">{{cite journal |vauthors=Shemesh E, Czerniak A |title=Comparison between Savary-Gilliard and balloon dilatation of benign esophageal strictures |journal=World J Surg |volume=14 |issue=4 |pages=518–21; discussion 521–2 |year=1990 |pmid=2382455 |doi= |url=}}</ref><ref name="pmid7818628">{{cite journal |vauthors=Cox JG, Winter RK, Maslin SC, Dakkak M, Jones R, Buckton GK, Hoare RC, Dyet JF, Bennett JR |title=Balloon or bougie for dilatation of benign esophageal stricture? |journal=Dig. Dis. Sci. |volume=39 |issue=4 |pages=776–81 |year=1994 |pmid=7818628 |doi= |url=}}</ref>       
** Mechanical ( bougie) that can be done with   
** Mechanical ( bougie) that can be done with   
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*** Nonguidewire such as maloney and hurst dilator 
*** Nonguidewire such as maloney and hurst dilator 
** Balloon dilators
** Balloon dilators
* Self-expandable plastic or metal stents placement <ref name="pmid14716840">{{cite journal |vauthors=Cheng YS, Li MH, Chen WX, Chen NW, Zhuang QX, Shang KZ |title=Complications of stent placement for benign stricture of gastrointestinal tract |journal=World J. Gastroenterol. |volume=10 |issue=2 |pages=284–6 |year=2004 |pmid=14716840 |pmc=4717021 |doi= |url=}}</ref><ref name="pmid15472671">{{cite journal |vauthors=Repici A, Conio M, De Angelis C, Battaglia E, Musso A, Pellicano R, Goss M, Venezia G, Rizzetto M, Saracco G |title=Temporary placement of an expandable polyester silicone-covered stent for treatment of refractory benign esophageal strictures |journal=Gastrointest. Endosc. |volume=60 |issue=4 |pages=513–9 |year=2004 |pmid=15472671 |doi= |url=}}</ref>  
* Self-expandable plastic or metal stents placement <ref name="pmid14716840">{{cite journal |vauthors=Cheng YS, Li MH, Chen WX, Chen NW, Zhuang QX, Shang KZ |title=Complications of stent placement for benign stricture of gastrointestinal tract |journal=World J. Gastroenterol. |volume=10 |issue=2 |pages=284–6 |year=2004 |pmid=14716840 |pmc=4717021 |doi= |url=}}</ref><ref name="pmid15472671">{{cite journal |vauthors=Repici A, Conio M, De Angelis C, Battaglia E, Musso A, Pellicano R, Goss M, Venezia G, Rizzetto M, Saracco G |title=Temporary placement of an expandable polyester silicone-covered stent for treatment of refractory benign esophageal strictures |journal=Gastrointest. Endosc. |volume=60 |issue=4 |pages=513–9 |year=2004 |pmid=15472671 |doi= |url=}}</ref>  
* Self dilation at home  with bougie dilators <ref name="pmid23925823">{{cite journal |vauthors=Dzeletovic I, Fleischer DE, Crowell MD, Pannala R, Harris LA, Ramirez FC, Burdick GE, Rentz LA, Spratley RV, Helling SD, Alexander JA |title=Self-dilation as a treatment for resistant, benign esophageal strictures |journal=Dig. Dis. Sci. |volume=58 |issue=11 |pages=3218–23 |year=2013 |pmid=23925823 |doi=10.1007/s10620-013-2822-7 |url=}}</ref>  
* Self dilation at home  with bougie dilators <ref name="pmid23925823">{{cite journal |vauthors=Dzeletovic I, Fleischer DE, Crowell MD, Pannala R, Harris LA, Ramirez FC, Burdick GE, Rentz LA, Spratley RV, Helling SD, Alexander JA |title=Self-dilation as a treatment for resistant, benign esophageal strictures |journal=Dig. Dis. Sci. |volume=58 |issue=11 |pages=3218–23 |year=2013 |pmid=23925823 |doi=10.1007/s10620-013-2822-7 |url=}}</ref>  
 
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* local steroid injection in refractory strictures by inhibiting collagen formation <ref name="pmid19439958">{{cite journal |vauthors=Pregun I, Hritz I, Tulassay Z, Herszényi L |title=Peptic esophageal stricture: medical treatment |journal=Dig Dis |volume=27 |issue=1 |pages=31–7 |year=2009 |pmid=19439958 |doi=10.1159/000210101 |url=}}</ref>  
* local steroid injection in refractory strictures by inhibiting collagen formation <ref name="pmid19439958">{{cite journal |vauthors=Pregun I, Hritz I, Tulassay Z, Herszényi L |title=Peptic esophageal stricture: medical treatment |journal=Dig Dis |volume=27 |issue=1 |pages=31–7 |year=2009 |pmid=19439958 |doi=10.1159/000210101 |url=}}</ref>  
* Pharyngoesophageal puncture in severe upper esophageal stenosis after radiation therapy for laryngeal and hypopharyngeal cancers  <ref name="pmid19517185">{{cite journal |vauthors=Tang SJ, Singh S, Truelson JM |title=Endotherapy for severe and complete pharyngo-esophageal post-radiation stenosis using wires, balloons and pharyngo-esophageal puncture (PEP) (with videos) |journal=Surg Endosc |volume=24 |issue=1 |pages=210–4 |year=2010 |pmid=19517185 |doi=10.1007/s00464-009-0535-y |url=}}</ref>  
* Pharyngoesophageal puncture in severe upper esophageal stenosis after radiation therapy for laryngeal and hypopharyngeal cancers  <ref name="pmid19517185">{{cite journal |vauthors=Tang SJ, Singh S, Truelson JM |title=Endotherapy for severe and complete pharyngo-esophageal post-radiation stenosis using wires, balloons and pharyngo-esophageal puncture (PEP) (with videos) |journal=Surg Endosc |volume=24 |issue=1 |pages=210–4 |year=2010 |pmid=19517185 |doi=10.1007/s00464-009-0535-y |url=}}</ref>  

Revision as of 19:06, 6 November 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

Surgical intervention is not recommended for the management of [disease name].

OR

Surgery is not the first-line treatment option for patients with [disease name]. Surgery is usually reserved for patients with either [indication 1], [indication 2], and [indication 3]OR

The mainstay of treatment for [disease name] is medical therapy. Surgery is usually reserved for patients with either [indication 1], [indication 2], and/or [indication 3].

OR

The feasibility of surgery depends on the stage of [malignancy] at diagnosis.

OR

Surgery is the mainstay of treatment for [disease or malignancy].

Surgery

5Nxz-OD2ogY|500}}

The most common cause of esophageal stricture is gastroesophageal reflux disease. Treatment for esophageal stricture is combination of dilation and  proton pump inhibitors or H2 antagonist therapy.[1]

  • Cautious dilation [2]
    • Caustic strictures
    • Radiation stricture
    • Eosinophilic esophagitis due to increased risk of perforation
    • Bleeding disorders
    • Severe cardiovascular disease or pulmonary disease
  • Dilators[2] [3][4]
    • Mechanical ( bougie) that can be done with
      • Guidewire such as savary-gilliard and eder-puestow olive dilators
      • Nonguidewire such as maloney and hurst dilator 
    • Balloon dilators
  • Self-expandable plastic or metal stents placement [5][6]
  • Self dilation at home  with bougie dilators [7]
FIRiPny4n6Y|500}}
  • local steroid injection in refractory strictures by inhibiting collagen formation [8]
  • Pharyngoesophageal puncture in severe upper esophageal stenosis after radiation therapy for laryngeal and hypopharyngeal cancers [9]

palliation of malignant esophageal strictures are stent placement (particularly in patients with an expected survival of 3 months or less) and brachytherapy (in patients with a life expectancy of more than 3 months)

  • Surgical intervention is not recommended for the management of [disease name].
  • feeding tube and gastrostomy for patients that are not good candidate for surgery

OR

  • Surgery is not the first-line treatment option for patients with esophageal stricture. Sent placement is usually reserved for patients with either
    • Malignant esophageal strictures with a life expectancy less than three months[10]
    • [Indication 2]
    • [Indication 3]
  • The mainstay of treatment for [disease name] is medical therapy. Surgery is usually reserved for patients with either:
    • [Indication 1]
    • [Indication 2]
    • [Indication 3]
  • The feasibility of surgery depends on the stage of [malignancy] at diagnosis.

OR

  • Surgery is the mainstay of treatment for [disease or malignancy].

Indications

References

  1. Smith PM, Kerr GD, Cockel R, Ross BA, Bate CM, Brown P, Dronfield MW, Green JR, Hislop WS, Theodossi A (1994). "A comparison of omeprazole and ranitidine in the prevention of recurrence of benign esophageal stricture. Restore Investigator Group". Gastroenterology. 107 (5): 1312–8. PMID 7926495.
  2. 2.0 2.1 Nostrant TT (2005). "Esophageal Dilation / Dilators". Curr Treat Options Gastroenterol. 8 (1): 85–95. PMID 15625037.
  3. Shemesh E, Czerniak A (1990). "Comparison between Savary-Gilliard and balloon dilatation of benign esophageal strictures". World J Surg. 14 (4): 518–21, discussion 521–2. PMID 2382455.
  4. Cox JG, Winter RK, Maslin SC, Dakkak M, Jones R, Buckton GK, Hoare RC, Dyet JF, Bennett JR (1994). "Balloon or bougie for dilatation of benign esophageal stricture?". Dig. Dis. Sci. 39 (4): 776–81. PMID 7818628.
  5. Cheng YS, Li MH, Chen WX, Chen NW, Zhuang QX, Shang KZ (2004). "Complications of stent placement for benign stricture of gastrointestinal tract". World J. Gastroenterol. 10 (2): 284–6. PMC 4717021. PMID 14716840.
  6. Repici A, Conio M, De Angelis C, Battaglia E, Musso A, Pellicano R, Goss M, Venezia G, Rizzetto M, Saracco G (2004). "Temporary placement of an expandable polyester silicone-covered stent for treatment of refractory benign esophageal strictures". Gastrointest. Endosc. 60 (4): 513–9. PMID 15472671.
  7. Dzeletovic I, Fleischer DE, Crowell MD, Pannala R, Harris LA, Ramirez FC, Burdick GE, Rentz LA, Spratley RV, Helling SD, Alexander JA (2013). "Self-dilation as a treatment for resistant, benign esophageal strictures". Dig. Dis. Sci. 58 (11): 3218–23. doi:10.1007/s10620-013-2822-7. PMID 23925823.
  8. Pregun I, Hritz I, Tulassay Z, Herszényi L (2009). "Peptic esophageal stricture: medical treatment". Dig Dis. 27 (1): 31–7. doi:10.1159/000210101. PMID 19439958.
  9. Tang SJ, Singh S, Truelson JM (2010). "Endotherapy for severe and complete pharyngo-esophageal post-radiation stenosis using wires, balloons and pharyngo-esophageal puncture (PEP) (with videos)". Surg Endosc. 24 (1): 210–4. doi:10.1007/s00464-009-0535-y. PMID 19517185.
  10. Siersema PD (2008). "Treatment options for esophageal strictures". Nat Clin Pract Gastroenterol Hepatol. 5 (3): 142–52. doi:10.1038/ncpgasthep1053. PMID 18250638.

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