P120 | ROLE OF Nd (YAG) LASER IN CORROSIVE ESOPHAGEAL STRICTURE: A COMPARATIVE STUDY |
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| Cardio-thoracic surgery unit, Alexandria University, Alexandria, Egypt | |
Objective: Accidental ingestion of potash by children is a serious problem leading to corrosive esophageal stricture. Various methods for esophageal dilatation were tried using either antegrade or retrograde dilators, but their results were unsatisfactory. We started to use laser (Nd: YAG) as a new technique for esophageal dilatation. This work evaluates the efficacy and morbidity of the different techniques for esophageal dilatation.
Methods: During the last six years, 220 patients with corrosive esophageal stricture were treated as follow: Group I: 109 patients, Gum elastic dilator, Group II: 24 patients, retrograde Tuckers dilator through a gastrostomy tube, Group III: 45 patients, wire guided Savarys dilator, Group IV: 22 patients, balloon dilator and Group V: 20 patients Nd (YAG) laser.
For laser dilatation we used a rigid esophagoscope under general anesthesia. The laser beam is applied to two opposite points to open the scarred ring using either the contact or the non-contact technique.
Results:
| Group | |||||
| I | II | III | IV | V | |
| Mean of dilatation | 7 | 9 | 6 | 3 | 3 |
| Satisfactory result | 77.9% | 79.2% | 88.8% | 90.9% | 95% |
| Perforation | 7.3% | ñ | 2.2% | ñ | 5% |
Conclusion: Savary, balloon and laser dilatation are safe and effective procedure for corrosive esophageal stricture with minimal morbidity and mortality. Yet Savarys dilator has the advantage of being cheap and can be used by junior staff after training.
