ENDOSCOPIC DEXAMETHASONE INJECTION FOLLOWING BALLOON DILATATION OF ANASTOMOTIC STRICTURE AFTER ESOPHAGOGASTROSTOMY

BACKGROUND: Anastomotic stricture is common after esophagogastrostomy. Recent advances in nonsurgical treatment include the silicon bougie a nd balloon dilatation. However, simple dilatation alone with a silicon bougie or endoscopic balloon dilator was repeated a mean of 4.7 +/- 5 .4 times to control anastomotic stricture because of its temporary eff ect. METHODS: For 11 patients, endoscopic injection of dexamethasone ( 8 mg) around the anastomosis was done immediately after balloon dilata tion (40 psi for 5 minutes). RESULTS: This method significantly reduce d the number of the dilatations to 1.1 +/- 0.3 (P < 0.05). Ten of the ii patients did not need any further treatment. There were no side eff ects or complications of dexamethasone injection. CONCLUSION: A combin ation of endoscopic balloon dilatation and dexamethasone injection pro vided an easy and safe method for preventing the recurrence of anastom otic stricture. (C) 1997 by Excerpta Medica, Inc.