| Objective:To analyze the efficacy and safety of Savary-Gilliard’s bougie dilation(SGBD),SGBD combined with fully covered self-expanding metal stent(FCSEMS)or endoscopic incision(EI)in the treatment of benign esophageal stenosis(BES)by gastroscopy,providing a theoretical basis for the selection of treatment methods for BES.Methods:A total of 163 patients who visited the First Affiliated Hospital of Nanchang University due to dysphagia from January 2014 to February 2021 were retrospectively collected.All patients were diagnosed as BES by gastroscopy and treated with SGBD,SGBD combined with FCSEMS and EI.The basic data of patients who met the criteria were collected.Results:A total of 163 BES patients were enrolled,including 105 patients in the bougie dilatation group,37 patients in the bougie combined with stent group,and 21 patients in the endoscopic incision group.The main cause of stenosis was anastom-otic stricture.The albumin in the endoscopic incision group was significantly higher than that in the other two groups(P=0.01).After 3 months of treatment in the three groups,the dysphagia remission rate in the bougie combined with stent and endoscopic incision group was significantly higher than that in the bougie dilatation alone group(P<0.05);after 6 months of treatment,the dysphagia remission rate in the bougie alone group was lower than that in the other groups(P=0.1);after 12 months of treatment,only the dysphagia remission rate in the bougie combined with stent and endoscopic incision group was greater than 50%,and there was no significant difference in the remission rate among the three groups(P=0.262).After the first treatment,the scores of dysphagia in the bougie dilatation group,the bougie combined with stent group and the endoscopic incision group were similar,and there was no significant difference(P=0.437),but there was statistical difference in dysphagia improvement scores(P = 0.014),with an increase of 0.467(P =0.004,95% CI: 0.15–0.78)in the endoscopic incision group compared with the bougie combined with stent group,and an increase of 0.439(P=0.017,95% CI: 0.08 –0.8)in the endoscopic incision group compared with the bougie combined with stent group.When the stooler score was 4,there was no significant difference between the three groups in stooler score and improvement of dysphagia and the efficacy of treatment after the first treatment(P>0.05).When stooler score was 3 points,the improvement of stooler score and dysphagia in the three groups after the first treatment was similar,and the difference had no statistical significance(P>0.05).The efficacy of bougie combined with stent and endoscopic incision group was better than that of bougie group(P=0.026);after 12 months,the treatment efficacy of the three groups was similar,and the difference had no statistical significance(P>0.05).Among the complications of the three treatment methods,esophageal fistula and chest pain were more likely to occur in the bougie combined with stent group than in the other groups,and the differences were statistically significant(P=0.031 and P<0.001),and there was no statistically significant difference in infection and bleeding(P=0.246).Conclusions:Bougie combined with stent and endoscopic incision was significantly superior to bougie dilatation alone in relieving dysphagia symptoms in BES in the short term;esophageal fistula and chest pain were more likely to occur with bougie combined with stent compared with bougie dilatation and endoscopic incision. |
