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Fluoroscopically guided dilation of esophageal strictures in patients with dystrophic epidermolysis bullosa: long-term results.
[dystrophic epidermolysis bullosa]
The
purpose
of
this
study
was
to
investigate
the
immediate
and
long
-term
outcomes
after
fluoroscopically
guided
balloon
dilation
of
esophageal
strictures
in
a
series
of
patients
with
dystrophic
epidermolysis
bullosa
(
DEB
)
.
Between
2005
and
2011
,
the
medical
records
of
all
patients
with
DEB
treated
with
fluoroscopically
guided
balloon
dilation
of
esophageal
strictures
were
included
in
the
study
and
retrospectively
analyzed
.
The
indication
for
treatment
was
dysphagia
attributed
to
at
least
one
radiologically
verified
esophageal
stricture
.
The
primary
endpoints
of
the
study
included
procedural
technical
success
,
clinical
improvement
assessed
with
a
0
-
4
dysphagia
score
,
and
major
complication
rate
.
Secondary
endpoints
were
patient
survival
and
reintervention
rates
.
Nineteen
consecutively
registered
patients
with
DEB
(
age
range
,
10
-
51
years
;
mean
,
30
±
12
.
2
years
)
and
dysphagia
due
to
esophageal
strictures
were
treated
with
fluoroscopically
guided
balloon
dilation
.
In
total
,
90
procedures
and
121
dilations
were
performed
to
manage
28
lesions
.
Balloon
diameter
ranged
from
8
to
18
mm
.
The
mean
follow-up
time
was
47
.
51
±
16
.
64
months
(
range
,
17
-
73
months
)
.
The
technical
success
rate
was
96
.
7
%
(
87
/
90
)
.
There
were
no
major
complications
.
The
mean
reintervention
rate
was
1
.
19
dilations
per
patient
per
year
,
and
the
postprocedural
dysphagia
score
(
0
.
72
[
95
%
CI
,
0
.
56
-
0
.
87
]
)
was
significantly
lower
than
baseline
(
2
.
50
[
95
%
CI
2
.
35
-
2
.
65
]
)
(
p
<
0
.
001
)
.
Repeated
fluoroscopically
guided
balloon
dilation
is
safe
and
effective
for
the
management
of
dysphagia
caused
by
esophageal
strictures
in
DEB
.
Use
of
this
technique
was
associated
with
marked
clinical
improvement
in
dysphagia
and
satisfactory
long
-term
reintervention
rates
with
no
major
complications
.
Diseases
Validation
Diseases presenting
"long-term outcomes"
symptom
acute rheumatic fever
alpha-thalassemia
aromatase deficiency
cholangiocarcinoma
classical phenylketonuria
congenital adrenal hyperplasia
congenital diaphragmatic hernia
cushing syndrome
dystrophic epidermolysis bullosa
esophageal squamous cell carcinoma
hirschsprung disease
homocystinuria without methylmalonic aciduria
kabuki syndrome
lamellar ichthyosis
omenn syndrome
phenylketonuria
proteus syndrome
trochlear dysplasia
von hippel-lindau disease
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