[Benign strictures of the esophagus: endoscopic approach with Savary-Gilliard bougies]

Benign esophageal strictures are complications that result from different causes. They are usually similarly approached, most of the cases needing endoscopic dilation. However the response to therapy, optimal timing for treatment and interval between sessions can vary.

The authors evaluate 14 years of experience with benign stricture of the esophagus from the endoscopic point of view in the 'Clementino Fraga Filho' University Hospital, Federal University of Rio de Janeiro, RJ, Brazil. They evaluated etiology, length of stricture, number of dilations needed to reach satisfactory therapeutic response, and the relation between length of stricture and therapeutic response.

We analyzed 2,568 endoscopic dilations using Savary-Gilliard dilators in 236 patients. The follow up period was 14 years and 10 months, until June of 2007.

Peptic strictures were the more frequent, followed by caustic strictures. Long strictures and caustic strictures needed more sessions to abolish dysphagia. Peptic strictures and short ones had better response to a smaller number of sessions.

In this study, peptic strictures were the commonest etiology and responded best to endoscopic therapy, in accordance with published literature. Caustic strictures were the most refractory, mainly the long segments. The longer the extension of stenosis, the greater was the number dilation sessions needed for relief. Short strictures had a good prognosis in the great majority of cases. The number of dilations depended directly on the etiology and the extension of the stricture.