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Schatzki's ring: to cut or break an unresolved problem.
Abeer Ibrahim1, Rhonda A Cole, Waqar A Qureshi
1Department of Medicine, Alexandria University, Alexandria, Egypt.
Digestive Diseases and Sciences
|May 14, 2004
Summary
Neither single Savary dilator dilation nor electrosurgical incision effectively treats symptomatic Schatzki
Area of Science:
- Gastroenterology
- Endoscopic Procedures
Background:
- Symptom assessment is less reliable than objective measures for peptic stricture dilation success.
- Schatzki's ring, a common cause of dysphagia, has a high recurrence rate after treatment.
- Current treatment efficacy for symptomatic Schatzki's rings requires objective evaluation.
Purpose of the Study:
- To compare the efficacy of single 54-F Savary dilator dilation versus electrosurgical ring incision for symptomatic Schatzki's rings.
- To assess treatment success using both subjective dysphagia scores and objective barium pill passage tests.
Main Methods:
- Randomized trial of 11 patients with symptomatic Schatzki's rings who failed a 12.7-mm barium pill test.
- Interventions included single 54-F Savary dilator dilation or four-quadrant needle-knife incision.
- Follow-up included dysphagia scores and barium pill passage tests at 1, 3, 6, and 12 months.
Main Results:
- Both dilation and incision significantly reduced dysphagia scores post-procedure.
- Objective barium pill passage tests showed failure in 60% at 1 month and 100% at 1 year.
- One patient experienced esophageal perforation following dilation.
Conclusions:
- Neither single large-dilator dilation nor ring incision provides reliable, long-term relief for symptomatic Schatzki's rings.
- Objective measures reveal limited long-term efficacy, suggesting potential need for repeated interventions.
- Further studies are needed to establish effective treatment protocols for Schatzki's ring.