Conservative management of benign oesophageal strictures

Over a four year period, 66 patients have undergone fibreoptic endoscopy and Eder Puestow dilatation for a presumed benign oesophageal stricture. Ten patients were subsequently shown to have carcinoma of the oesophagus. There were 121 dilatations with only one perforation, which healed with conservative treatment. Twenty eight of the 56 patients with a benign stricture have required only one dilatation with relief of dysphagia during follow-up periods ranging from 11 months to 61 months (mean 29 months). In those requiring repeat dilatations, relief has been obtained for periods ranging from two weeks to 35 months (mean 6 months). Mean time to restricture in the carcinoma group was two weeks. We conclude that the Eder Puestow method is safe, well tolerated, and less than 5% will require surgery. Strictures which recur rapidly should arouse suspicion of malignancy.