E.A. Godzhello, T.V. Belisova, N.A. Bulganina, M.V. Khrustaleva
Petrovsky National Research Center of Surgery, Moscow
Belisova Tamara V. — Endoscopist, Junior Scientific Employee of the Endoscopy Department of the Petrovsky National Research Center of Surgery
2 Abrikosovskiy alley, Moscow, 119991, Russian Federation, tel. +7-915-353-50-88, e-mail: kirsanova-tamara@mail.ru, Author ID: 1136646, SPIN-код: 9475-8727, ORCID ID: 0000-0001-5510-9140
Abstract. Approximately one third of patients with complex strictures of the esophagus and esophageal anastomoses develop restenosis after a course of endoscopic bougienage. To prevent this, we have developed a tactic of long-term planned maintenance bougienage for 6-24 months, which is successfully used in the clinical practice of the endoscopy department of the Petrovsky National Research Center of Surgery for many years. Recently, to improve the results of endoscopic bougienage of refractory benign esophageal and esophageal anastomotic strictures and strictures with the tendency to restenosis or recurrence, we have been using intramural steroid injections according to our scheme. To date, the technique has been applied in 65 patients (esophageal strictures — 44, strictures of esophageal anastomoses — 21). Comparison of the immediate results of endoscopic bougienage, supplemented by the introduction of Dexamethasone and Kenalog, showed the advantage of the latter. There were no complications of intramural steroid therapy in the course of endoscopic bougienage. Our still little experience with the use of intramural injections of triamcinolone acetate (Kenalog) in the course of long-term planned endoscopic bougienage of complex recurrent and refractory strictures of the esophagus and esophageal anastomoses indicates that this technique is promising.
Key words: esophageal stricture, anastomotic stricture, endoscopic bougienage, intramural injections, steroids, triamcinolone (Kenalog).