Mahmoud ElFiky

Aim of the Study :Outcome study of managing resistant post corrosive oesophageal strictures by Savary-Gilliard dilatation in patients referred to our department for oesophageal replacement after several attempts of endoscopic dilatation

Methods: Dilatation starts six weeks after patient stabilization, under general anesthesia & complete muscle relaxation, using Savary-Gilliard dilators combined with fluoroscopic imaging. After several attempts of dilatation, failed cases undergo oesophageal replacement (colon bypass or gastric tube oesophagoplasty) & complications are managed accordingly. Patients are followed up for assessment of growth, dysphagia fr quality of life by questionnaire for at least 12 months on outpatient basis.

Main Results :58 Cases were studied (male: female ratio 1:1) with mean age 3.65 years (range 0.5-13) with various stricture aetiologies (52 post corrosive ingestion, 2 traumatic injuries & 4 post anastomotic esophageal atresia). All received 149 dilatations (mean = 2.56) with 71% success rate. Failed dilatation cases received oesophageal replacement, limited stricturoplasty or secondary dilatation by Savary- Gilliard dilators. Outcome showed symptomatic relief from dysphagia in 776%, normal growth pattern & improvement in quality of life pattern.

Conclusion :Savary-Gilliard dilatation is an effective option for management of resistant oesophageal strictures to preserve the native oesophagus. It has better outcome than resorting to surgeries, which should be limited to intractable