| Endoscopic Management of Difficult or Recurrent Esophageal Strictures. | |
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MedLine Citation:
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PMID: 22008891 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Esophageal strictures are a common problem in gastroenterological practice. In general, the management of malignant or benign esophageal strictures is different and requires a different treatment approach. In daily clinical practice, stent placement is a commonly used modality for the palliation of incurable malignant strictures causing dysphagia, whereas, if available, intraluminal brachytherapy can be considered in patients with a good performance status. Recurrent dysphagia frequently occurs in malignant cases. In case of tissue in- or overgrowth, a second stent is placed. If stent migration occurs, the stent can be repositioned or a second (preferably partially covered) stent can be placed. Food obstruction of the stent lumen can be resolved by endoscopic cleansing. The cornerstone of the management of benign strictures is still dilation therapy (Savary-Gilliard bougie or balloon). There are a subgroup of strictures that are refractory or recur and an alternative approach is required. In order to prevent stricture recurrence, steroid injections into the stricture followed by dilation can be considered. In case of anastomotic strictures or Schatzki rings, incisional therapy is a safe method in experienced hands. Temporary stent placement is a third option before considering self-bougienage or surgery as a salvage treatment. In this review, the most frequently used endoscopic treatment modalities for malignant and benign stricture management will be discussed based on the available literature, and some practical information for the management in daily clinical practice will be provided.Am J Gastroenterol advance online publication, 18 October 2011; doi:10.1038/ajg.2011.348. |
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Authors:
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Laetitia R H de Wijkerslooth; Frank P Vleggaar; Peter D Siersema |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-10-18 |
Journal Detail:
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Title: The American journal of gastroenterology Volume: - ISSN: 1572-0241 ISO Abbreviation: - Publication Date: 2011 Oct |
Date Detail:
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Created Date: 2011-10-19 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0421030 Medline TA: Am J Gastroenterol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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