Technical feasibility, clinical effectiveness, and safety of esophageal stricture dilation using a novel endoscopic attachment cap in adults with eosinophilic esophagitis.

Schoepfer, Alain M; Henchoz, Sarah; Biedermann, Luc; Schreiner, Philipp; Greuter, Thomas; Reinhard, Antoine; Senn, Jonduri; Franke, Annett; Burri, Emanuel; Juillerat, Pascal; Simon, Hans-Uwe; Straumann, Alex; Safroneeva, Ekaterina; Godat, Sébastien (2021). Technical feasibility, clinical effectiveness, and safety of esophageal stricture dilation using a novel endoscopic attachment cap in adults with eosinophilic esophagitis. Gastrointestinal endoscopy, 94(5), 912-919.e2. Elsevier 10.1016/j.gie.2021.05.017

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BACKGROUND AND AIMS

BougieCap (Ovesco Endoscopy AG, Tübingen, Germany) is a new device that allows optical and tactile feedback during stricture dilation of the upper gastrointestinal tract. We evaluated the technical feasibility, clinical efficacy, and safety of a one-time esophageal stricture dilation using BougieCap in adults with eosinophilic esophagitis (EoE).

METHODS

EoE patients prospectively included in the Swiss EoE Cohort were dilated with BougieCap in case of the presence of esophageal strictures (esophageal diameter ≤14 mm) and stricture-related symptoms. Symptoms were assessed before and 2 weeks after a single dilation session using the validated Eosinophilic Esophagitis Activity Index Patient Reported Outcomes (EEsAI PRO)instrument (score ranges from 0-100 points).

RESULTS

Fifty patients (70% male, median age 41 years, median disease duration of 4 years, 50% treated with swallowed topical corticosteroids, 10% with proton pump inhibitors, 14% with combined swallowed topical corticosteroids plus proton pump inhibitors, 14% with elimination diet, 12% without anti-eosinophil therapy) were evaluated. Endoscopic bougienage was technically successful in 100%. Median esophageal diameter increased from 12 mm (IQR 12-13) to 16 mm (IQR 16-16, p<0.001)). Median symptom severity dropped from 32 points (IQR 27-41) to 0 (IQR 0-10, p<0.001) at 2 weeks post dilation. In one patient the BougieCap was temporarily lost after stricture dilation in the hypopharynx but could be retrieved. No severe adverse events were reported.

CONCLUSIONS

In adults with EoE, endoscopic treatment of esophageal strictures using BougieCap is technically feasible, safe and offers significant symptomatic improvement in the short term.

Item Type:

 Journal Article (Original Article)

Division/Institute:

 04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Pharmacology
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Gastroenterology

UniBE Contributor:

 Juillerat, Pascal, Simon, Hans-Uwe, Safroneeva, Ekaterina

Subjects:

 600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

 0016-5107

Publisher:

 Elsevier

Funders:

 [4] Swiss National Science Foundation

Language:

 English

Submitter:

 Andrea Flükiger-Flückiger

Date Deposited:

 27 May 2021 18:23

Last Modified:

 18 Jan 2023 11:43

Publisher DOI:

 10.1016/j.gie.2021.05.017

PubMed ID:

 34004192

Additional Information:

Safroneeva and Godat contributed equally to this work.

Uncontrolled Keywords:

 BougieCap Eosinophilic esophagitis bougienage dilation fibrostenosis stricture

BORIS DOI:

 10.48350/156521

URI:

 https://boris.unibe.ch/id/eprint/156521

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