양성 식도문합부 협착의 치료로써 침형절개도를 이용한 전기소작 확장술과 스테로이드 국소주사 병합요법의 유용성

Abstract

BACKGROUND/AIMS: The endoscopic incision for the treatment of benign esophageal anastomotic stricture (BEAS) was uncommonly reported because of the frequent recurrence of stricture. Intralesional steroid injection has been shown to be effective in prevention of recurrence, so we have performed the combination therapy with endoscopic incision and intralesional steroid injection. METHODS: Fourteen patients with BEAS were treated with endoscopic radial cuts using needle-knife papillotome together with intralesional injection of triamcinolone. The mean age of the 14 patients was 58.1 and mean follow-up days was 205.8 (65~439). RESULTS: The onset of BEAS were 135.6+/-73.0 days and significantly early in patients with distorted stapling (p=0.012). After treatment the diameter of stricture was significantly increased (p=0.001) and the dysphagia was improved above 2 degrees. Initial dilatation was successfully done in one session and there was 10 cases of mild bleeding. The stricture recurrence was developed in 4 cases (30.7%), which showed tendency in long length of stricture (p=0.12) and significance in distorted stapling (p=0.007). CONCLUSIONS: The combination therapy with endoscopic incision and steroid injection may be useful method for the treatment of BEAS, but further long-term follow-up and comparative study were needed.