The safety of combined endoscopy, biopsy and dilation in esophageal strictures

The evaluation and management of esophageal strictures ordinarily involves the three procedures of endoscopy, biopsy, and dilation at different times. The safety of performing these procedures in a single sitting was evaluated. The study included 48 patients (ages 44-85) with radiographically confirmed esophageal strictures located in the upper third (3/48), middle third (18/48), and lower third (27/48) of the esophagus. The strictures were determined to be due to peptic esophagitis of varying severity (28/48) or carcinoma (20/48). Dilation immediately followed endoscopy and biopsy with an average of three mercury-weighted dilators passed at this sitting. The size and type of dilators were determined clinically by the endoscopic estimation of esophageal lumen diameter. Anesthesia included topical Cetacaine and intravenous diazepam (5-15 mg.). All patients experienced symptomatic improvement immediately following the procedures. No complications were encountered. These data indicate that endoscopy, biopsy and dilation of esophageal strictures may safely be performed in a single sitting. Other advantages may include shortened hospital stay, earlier diagnosis and relief of symptoms and increased cost effectiveness.