Treatment of Benign Esophageal Stricture by Eder-Puestow or Balloon Dilators: A Comparison Between Randomized and Prospective Nonrandomized Trials

Radiologically guided balloon dilatation of obstructing gastrointestinal strictures

“…Dilatation was successful in 93% of tightly stenotic rectal lesions. These figures compare favorably with other series reported in the literature of dilatation of variety of strictures using various techniques [10,14,17,18]. Our complication rate was very low, with no major complications.…”

“…Our "technical failures" had all been surgical or endoscopic "failures" prior to referral for radiological dilatation, and several "failed" surgical and endoscopic dilatations were managed successfully by radiologically guided balloon dilatation. All methods of dilatation of GIT strictures seem to be similar in efficacy [18,19]. Some authors claim that balloon dilatation gives longer lasting symptom relief than bougienage [20], but the real bonus of balloon dilatation is its relative safety, thought to be due to the manner in which the dilating force is exerted radially on the stricture [15].…”

“…The reported perforation rate with bougie dilatation varies between 0.4% and 8% [18,23]. Apart from safety considerations, dilatation using progressively larger bougies requires repeated intubation which is uncomfortable for the patient.…”

Comparative study of balloon and metal olive dilators for endoscopic management of benign anastomotic rectal strictures: clinical and cost-effectiveness outcomes

“…The exact role of Eder-Puestow metal olivary tips in the management of postoperative rectal strictures has rarely been explored [3,34], in contrast to their well-established application in benign esophageal strictures [35,36]. Major concerns about their implementation are derived from the fear of their traumatic impact on the bowel wall, leading to a putative high risk of complications, as well as the prerequisite of proper guidewire placement through the stenosis, which is not always achievable.…”

Diagnosis and initial management of Gastroesophageal complications

“…Since balloon dilators apply force at one general area, in theory it is thought to have less shear stress. Although the mechanism of accomplishing dilation differs between the methods, there is no distinct advantage between the two unless it is desired to avoid longitudinal forces, for example in tracheoesophageal voice prosthesis and epidermolysis bullosa [16][17][18][19]. Mechanical dilators can either be passed freely into the oesophagus or introduced through a guide wire.…”