Intralesional steroid injection therapy in the management of resistant gastrointestinal strictures

查看全文 作　　者：Rakesh [1]Kochhar;Kuchhangi Suresh [1]Poornachandra

机构地区：[1]Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India

出　　处：《World Journal of Gastrointestinal Endoscopy》索引2010年第2卷第2期,共8页

摘　　要：Esophageal strictures are a problem frequently encountered by gastroenterologists. Dilation has been the customary treatment for benign esophageal strictures, and dilation techniques have advanced over the years. Depending on their characteristics and the response to treatment, esophageal strictures can be classified into two types: 1, simple (Schatzki rings, webs, peptic injury, and following sclerotherapy) - these are easily amenable to dilation, with a low recurrence rate after initial treatment; and 2, complex (caused by caustic ingestion, radiation injury, anastomotic strictures, and photodynamic therapy) - these are difficult to dilate and are associated with higher recurrence rates. Refractory strictures are those in which it is not possible to relieve the anatomic restriction successfully up to a diameter of 14 mm over five sessions at 2-weekly in- tervals, due to cicatricial luminal compromise or fibrosis; and recurrent strictures are those in which it is not possible to maintain a satisfactory luminal diameter for 4 wk once the target diameter of 14 mm has been achieved. There are no standard recommendations for the management of refractory strictures. The various techniques used include intralesional steroid injectioncombined with dilation; endoscopic incisional therapy, with or without dilation; placement of self-expanding metal stents, Polyflex stents, or biodegradable stents; self-bougienage; and endoscopic surgery. This review discusses the indications, technique, results, and complications of the use of intralesional steroid injections combined with dilation and endoscopic incisional therapy with dilation in refractory strictures. 关键词：GASTROINTESTINAL STRICTURES INTRALESIONAL injection TRIAMCINOLONE STEROIDS DILATION Endoscopy

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Intralesional steroid injection therapy in the management of resistant gastrointestinal strictures

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