Single‐session, graded esophageal dilation without fluoroscopy in outpatients with lower esophageal (Schatzki’s) rings: A prospective, long‐term follow‐up study

Sgouros, Spiros; Vassiliadis, Konstantinos; Bergele, Christina; Vlachogiannakos, Jiannis; Stefanidis, Gerasimos; Mantides, Apostolos

doi:10.1111/j.1440-1746.2006.04368.x

Cited by 8 publications

(12 citation statements)

References 24 publications

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“…Similar to the findings in the current investigation, Eckardt et al [20] found recurrences unpredictable and unrelated to the initial ring diameter or the presence or absence of reflux esophagitis. Different from the observation that recurrence was unrelated to the type of endoscopic treatment [30], the present investigation showed that patients treated with a large bougie diameter (C52 F) had a tendency for a longer time until symptomatic recurrence. This discrepancy might possibly be explained by differences in completeness and length of follow-up or by differences in the definition of remission.…”

Section: Discussioncontrasting

confidence: 67%

Long-Term Recurrence Rates Following Dilation of Symptomatic Schatzki Rings

et al. 2010

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Section: Discussioncontrasting

confidence: 67%

Long-Term Recurrence Rates Following Dilation of Symptomatic Schatzki Rings

et al. 2010

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“…Gastroesophageal reflux disease (GERD) is believed to contribute to the formation of esophageal rings and has been reported in more than half of patients with Schatzki rings . Supporting the role of GERD is the observation that PPIs have been associated with a decreased likelihood of recurrence, at least among patients with documented GERD . One series, for example, reported a 0% recurrence in dysphagia after dilation at a mean of 43 months in patients who had objective evidence of GERD and who were taking a PPI.…”

Section: Discussionmentioning

confidence: 99%

“…Prospective series have demonstrated that symptom recurrence is common. 3,16,20,22 In an illustrative series of 61 patients who were followed for an average of 6 years, 63% required further dilatation for recurrent dysphagia. 22 Another study evaluated 33 patients after dilatation to ≥50 French.…”

Section: Discussionmentioning

confidence: 99%

“…However, almost one third have recurrent symptoms within the first year, and up to 100% have recurrence with longer follow-up (range 4-100%). 3,[15][16][17][18][19][20] Because of the high rate of recurrence, several approaches have been tried to improve long-term outcomes. One such approach involves obtaining four-quadrant biopsies, which permits the remaining tissue to deflect distally during passage of a food bolus.…”

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confidence: 99%

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Obliteration of symptomatic Schatzki rings with jumbo biopsy forceps (with video)

et al. 2014

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A Schatzki ring is a submucosal, fibrotic thickening located at the gastroesophageal junction. Endoscopic treatment traditionally involves disruption of the ring. Many approaches have been described including bougies, balloons, biopsies, and diathermic monopolar incision. While all of these approaches are effective in the short-term, recurrence is common. The objective of our study was to evaluate the feasibility of complete excision of the ring using jumbo cold biopsy forceps. Our main outcome measurements were the feasibility, safety, and efficacy of complete obliteration of Schatzki rings using jumbo cold biopsy forceps. We designed an observational study using a standard protocol for patient management and data collection using a university hospital as our setting. We followed 10 patients with dysphagia due to a Schatzki's ring, six of whom had previously undergone bougienage or balloon dilation. Five patients were on maintenance therapy with a proton pump inhibitor and one with an H2 blocker. Complete endoscopic obliteration of the Schatzki rings with a cold jumbo biopsy forceps was achieved in all 10 patients requiring a mean of 9.8 biopsies (range 8-12). Omeprazole (20 mg twice daily) was prescribed after the procedure. All 10 patients demonstrated improvement in dysphagia after treatment, which persisted during a mean follow-up time of 379 days (range 63-496 days). There were no serious complications. The limitations of our study include lack of a control group, a small sample size, and being a single-institution study. We concluded that complete Schatzki ring obliteration with jumbo cold biopsy forceps is a safe, feasible, and effective endoscopic treatment.

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“…Schatzki’s ring is associated with gastro-oesophageal reflux 39 102 103 and with eosinophilic oesophagitis, even in the absence of other endoscopic oesophageal mucosal abnormalities. 100 102 This may explain why patients with rings and acid reflux (demonstrated by pH monitoring), and also unselected patients with Schatzki’s rings appear to have fewer recurrences after dilatation when receiving PPI therapy.…”

Section: Disease-specific Considerationsmentioning

confidence: 99%

UK guidelines on oesophageal dilatation in clinical practice

Sami

Haboubi

Ang

et al. 2018

Gut

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These are updated guidelines which supersede the original version published in 2004. This work has been endorsed by the Clinical Services and Standards Committee of the British Society of Gastroenterology (BSG) under the auspices of the oesophageal section of the BSG. The original guidelines have undergone extensive revision by the 16 members of the Guideline Development Group with representation from individuals across all relevant disciplines, including the Heartburn Cancer UK charity, a nursing representative and a patient representative. The methodological rigour and transparency of the guideline development processes were appraised using the revised Appraisal of Guidelines for Research and Evaluation (AGREE II) tool.Dilatation of the oesophagus is a relatively high-risk intervention, and is required by an increasing range of disease states. Moreover, there is scarcity of evidence in the literature to guide clinicians on how to safely perform this procedure. These guidelines deal specifically with the dilatation procedure using balloon or bougie devices as a primary treatment strategy for non-malignant narrowing of the oesophagus. The use of stents is outside the remit of this paper; however, for cases of dilatation failure, alternative techniques—including stents—will be listed. The guideline is divided into the following subheadings: (1) patient preparation; (2) the dilatation procedure; (3) aftercare and (4) disease-specific considerations. A systematic literature search was performed. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool was used to evaluate the quality of evidence and decide on the strength of recommendations made.

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Single‐session, graded esophageal dilation without fluoroscopy in outpatients with lower esophageal (Schatzki’s) rings: A prospective, long‐term follow‐up study

Cited by 8 publications

References 24 publications

Long-Term Recurrence Rates Following Dilation of Symptomatic Schatzki Rings

Long-Term Recurrence Rates Following Dilation of Symptomatic Schatzki Rings

Obliteration of symptomatic Schatzki rings with jumbo biopsy forceps (with video)

UK guidelines on oesophageal dilatation in clinical practice

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