[Peptic stricture of the esophagus: long term outcome of conservative treatment].

BACKGROUND Endoscopic dilatation of esophageal strictures is a simple and safe procedure. AIM To analyze the long term outcome of conservative treatment for esophageal peptic stricture in patients with high surgical risk. PATIENTS AND METHODS Twenty consecutive patients, 13 male, whose mean age was 75.2 years, with a peptic stricture of the esophagus and high surgical risk were prospectively studied. All were subjected to endoscopic esophageal dilatation and treated with continuous medical antireflux therapy thereafter. RESULTS Only five patients complied with antireflux treatment on a regular basis. The remaining 15 were non compliant or abandoned it. A total of 56 dilatations were done (mean 2.8 per patient, range 1-6). No complications were observed after the procedure. With a mean follow up period of 49 months, the outcome of the conservative treatment was classified as excellent or good in all the cases. Eight patients (40%) died of causes unrelated to the treatment. Two patients had an organic foreing body impactation. This situation was solved endoscopically in both. CONCLUSION In high risk patients, endoscopic dilatation, with or without regular antireflux medical treatment is a simple, safe and effective therapy in the management of peptic oesophagel stenosis.