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This document provides practical recommendations for the use of esophageal dilation for treatment of benign and malignant strictures of the esophagus. It covers indications, contraindications, methods, complications, and outcomes of esophageal dilation.
Sep 21, 2024 · Esophageal dilation is a treatment to help stretch, or dilate, abnormal narrowings found in the esophagus. These narrowings are called strictures and can occur from a variety of health problems. They can cause difficulty or discomfort when swallowing.
The Maloney (Medovations, USA) is the most commonly used bougie dilator. Made of rubber and filled with mercury or tungsten, it has a tapered tip and is freely passed without a guidewire. The Savary-Gilliard (Wilson-Cook, USA) is a tapered thermoplastic dilator and is passed over a guidewire.
Historically, most benign esophageal strictures have been dilated with mercury-filled Hurst or Maloney dilators. 1,4 Long, acutely angulated, eccentric, or extremely tight (less than 7 mm) stenoses have traditionally necessitated guidewire-facilitated dilation.
Esophageal dilation is performed for treatment of symptomatic anatomical or functional narrowing of the esophagus, caused by a variety of benign and malignant conditions 1,2.
Many young gastroenterologists have no knowledge of, or experience with, Maloney dilators. As no additional tools are needed for Maloney dilators, dilation of a stenosed stomal tract and placement of a new gastrostomy tube can be performed by a single provider.
One-third of respondents reported the “routine” empiric use of a single Maloney dilator, while another third reported the “occasional” use of empiric dilation. 13 Lavu et al. reported that 67% of all esophageal dilations at an academic institution were performed to treat non-obstructive dysphagia. 11 Our study revealed similarly that ...
