TY  - BOOK
AU  - Hamdoun,Fatima-Zahra
AU  -  Abid,Hakima
AU  -  El Yousfi,Mounia
AU  -  El Abkari,Mohamed
AU  -  Ibrahimi,Adil
AU  -  Benajah,Dafr-Allah
AU  -  Lahmidani,Nada
TI  - Refractory peptic esophageal strictures: Observations at the gastroenterology department of Fes
PY  - 2022///.
							
N1  - 19
N2  - Peptic stenosis (PS) is a benign complication of gastroesophageal reflux disease (GERD). Several methods are used to treat it, including endoscopic dilation combined with antisecretory treatment. If there is no improvement after 3 to 5 dilations, alternative therapy should be considered. The aim of this study is to evaluate the predictive factors for the occurrence of refractory esophageal stenosis. Methods This was a retrospective study spread over a period of 16 years between January 2002 and March 2019, including all patients presenting with dysphagia ± regurgitation with endoscopic and/or radiological presentations indicative of peptic stenosis. Refractory strictures were defined by strictures requiring more than five sessions with short recurrence intervals (less than 4 weeks). Results Of the 123 patients who underwent endoscopic dilation for peptic stenosis, 13% (N = 16) presented with refractory stenosis. The mean age was 53.5 years [17-86]. The M/F sex ratio was 4 with male predominance. Tobacco use was found in 19% (N = 3) and alcohol in 1 patient. In all of our patients we noted chronic gastroesophageal reflux with a mean duration of 6.75 years [1– 17], regurgitation in 75% (N = 12), and heartburn in 19% (N = 3). Dysphagia was mixed in 25% (N = 4). Endoscopy revealed impassable stenosis in 81% (N = 13) and double stenosis in 6% (N = 1). Three quarters of our patients were dilated by progressive diameter candles. The mean number of dilations was 3.1 ± 1.92 sessions/person. After 5 endoscopic dilations, only 37% (N = 6) underwent surgery, and only one patient had an esophageal prosthesis; the other patients continued the endoscopic dilation sessions. Upon univariate and multivariate analysis, refractory stenosis was found to be significantly associated with the duration of gastroesophageal reflux (p = 0.01) and poor adherence to consolidation treatment based on proton pump inhibitors (P = 0.005). Conclusion Refractory strictures were present in 13% of the patients in our group, including patients with long-standing chronic gastroesophageal who had not received PPI-based consolidation therapy
UR  - https://shs.cairn.info/journal-cahiers-sante-medecine-therapeutique-2022-1-page-35?lang=en&redirect-ssocas=7080
ER  -