Esophageal dilation can be done safely using selective fluoroscopy and single dilating sessions

R. A. Kozarek, D. J. Patterson, T. J. Ball, M. G. Gelfand, G. E. Jiranek, J. E. Bredfeldt, J. J. Brandabur, H. W. Wolfsen, S. L. Raltz

Research output: Contribution to journalArticle

37 Scopus citations

Abstract

Maxims for safe esophageal dilation have included recommendations to use fluoroscopy in all instances and to limit dilation sessions to 2-mm increments. We reviewed a 34-month experience of all esophageal dilations undertaken at a large multispecialty clinic to define adherence to these recommendations and to delineate whether deviation was associated with significant complications. Four hundred thirty-two patients underwent 716 courses of esophageal dilation during this time, 92% of whom had benign disease. Eighty-nine percent of patients were dilated with polyvinyl dilators (Savary/American) and only 8% of these patients required fluoroscopic monitoring for the bougienage. Seventy-eight percent of the dilating sessions for patients without achalasia were undertaken using either a single large dilator (≥45 Fr) or employed incremental dilator sizes >2 mm (6 Fr) in a single session. There was a single perforation in 662 nonachalasia dilations and this was a consequence of attempted placement of an esophageal endoprosthesis. We conclude that use of guide wire technology and newer dilating techniques do away with the need for routine fluoroscopic control. Moreover, single large dilators or dilator increments >2 mm may be safely used, contingent on endoscopic stricture assessment.

Original languageEnglish (US)
Pages (from-to)184-188
Number of pages5
JournalJournal of clinical gastroenterology
Volume20
Issue number3
DOIs
StatePublished - Apr 1995

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Keywords

  • Achalasia
  • Bougienage
  • Dilation
  • Endoscopy
  • Esophageal stricture
  • Fluoroscopy

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Kozarek, R. A., Patterson, D. J., Ball, T. J., Gelfand, M. G., Jiranek, G. E., Bredfeldt, J. E., Brandabur, J. J., Wolfsen, H. W., & Raltz, S. L. (1995). Esophageal dilation can be done safely using selective fluoroscopy and single dilating sessions. Journal of clinical gastroenterology, 20(3), 184-188. https://doi.org/10.1097/00004836-199504000-00003