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Oesophageal Strictures (oesophageal + stricture)
Selected AbstractsLichen planus: an unusual cause of oesophageal strictureJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 5 2007C Bachmeyer [source] Systematic review: the epidemiology of gastro-oesophageal reflux disease in primary care, using the UK General Practice Research DatabaseALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 5 2009H. EL-SERAG Summary Background, Gastro-oesophageal reflux disease (GERD) is a common diagnosis in primary care; however, there has been no comprehensive review of the epidemiology of GERD in this setting. Aim, To review systematically articles that used the General Practice Research Database to study the epidemiology of GERD. Methods, Systematic literature searches. Results, Seventeen articles fulfilled the inclusion criteria. The incidence of GERD in primary care was 4.5 new diagnoses per 1000 person-years in 1996 (95% CI: 4.4,4.7). A new diagnosis of GERD was associated with being overweight, obese or an ex-smoker. Prior diagnoses of ischaemic heart disease, peptic ulcer disease, nonspecific chest pain, nonspecific abdominal pain, chronic obstructive pulmonary disease and asthma were associated with a subsequent new GERD diagnosis. A first diagnosis of GERD was associated with an increased risk of a subsequent diagnosis of oesophageal adenocarcinoma, oesophageal stricture, chronic cough, sinusitis, chest pain, angina, gallbladder disease, irritable bowel syndrome or sleep problems. Mortality may be higher in patients with a GERD diagnosis than in those without in the first year after diagnosis, but not long term. Conclusion, The General Practice Research Database is an effective way of studying the epidemiology of GERD in a large population-based primary care setting. [source] Systematic review: the role of self-expanding plastic stents for benign oesophageal stricturesALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 12 2010A. REPICI Aliment Pharmacol Ther,31, 1268,1275 Summary Background, Treatment of refractory or recurrent benign oesophageal strictures is demanding and surgery may be the only available option. The role of self-expanding plastic stents (SEPS) in the treatment of these strictures is still controversial because of the conflicting results of various studies. Aim, To analyse with regard to SEPS: technical and clinical success, factors associated with outcome, and safety. Methods, Pooled-data analysis of a systematic review of the literature. Clinical success was defined as no need for further endoscopic or surgical treatment after SEPS removal. Results, Data of 10 studies with 130 treated patients were included. SEPS insertion was technically successful in 128 of 130 patients (98%, 95% CI = 96,100%). Clinical success was achieved in 68 patients (52%, 95% CI = 44,61%) and this was found to be lower in those with a cervical localization of the stricture (33% vs. 54%; P < 0.05). Early (<4 weeks) migration of the stent was reported in 19 (24%, 95% CI = 14,32%) cases, while post-insertion endoscopic re-intervention was required in 25 (21%, 95% CI = 14,28%). Major clinical complications occurred in 12 patients (9%, 95% CI = 4,14%), resulting in death of one (0.8%) patient. Conclusions, Our pooled-data analysis showed a favourable risk/benefit ratio when SEPS are applied in patients with recurrent or refractory benign oesophageal strictures. This supports the use of SEPS before referring patients to surgery, and they are a valuable alternative to repeat endoscopic dilation. [source] Temporal trends in new and recurrent oesophageal strictures in a Medicare populationALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 10 2007H. B. EL-SERAG SUMMARY Background, The widespread use of proton pump inhibitors for gastro-oesophageal reflux disease could result in a decline in new as well as recurrent gastro-oesophageal reflux disease-related oesophageal strictures. The temporal trends of strictures have not been examined in population-based studies. Methods, To examine the temporal trends in strictures, we calculated the age-adjusted incidence rates of new oesophageal strictures with or without oesophageal dilation in a sample of Medicare beneficiaries between 1992 and 2000. We also examined recurrent dilations recorded at least 3 months after a new stricture or the preceding recurrent stricture. Results, The age-adjusted rates for strictures accompanied with dilation declined by approximately 11% from 215 per million to 192 per million. New oesophageal strictures with dilation declined as a proportion of all upper endoscopies procedures (from 2.6% to 1.9%). Recurrent dilation within 1 year declined dramatically from 16% (9.5% CI: 12.5,20.3) in 1992 to 8% (95% CI: 4.43,10.62) in 2000. In multivariable proportional hazards model, there was a 30% risk reduction of recurrent oesophageal strictures. Conclusions, This population-based study indicates that the incidence of new as well as recurrent oesophageal strictures has been declining. In the face of rising incidence of other gastro-oesophageal reflux disease-related complications, it is important to understand the explanation of the present observations. [source] | ||||||||||