Outcome of endoscopic therapeutic interventions: are they different among various non-malignant esophageal diseases

Rustam Khan, Aga Khan University
Shahab Abid, Aga Khan University
Saeed Hamid, Aga Khan University
Zaigham Abbas, Aga Khan University
Hasnain Shah, Aga Khan University
Wasim Jafri, Aga Khan University


Background: This study was carried out to evaluate and compare the outcome of various causes of non-malignant lesions of the esophagus after endoscopic therapeutic intervention.Methods: A cohort of patients with non-malignant dysphagia presenting at Aga Khan University hospital, a tertiary care setting who underwent endoscopic intervention was studied. Response to treatment was evaluated by improvement in dysphagia score on a scale of 0-4 and weight gain.Results: 99 subjects (53 males) were included. Mean age was 48.6 +/- 17.2 years. Dysphagia for solids was present in 48%, for liquids in 3% and for both in 49% patients. Significant weight loss (>10% body weight) occurred in 35 (35.3%) patients. Achalasia was diagnosed in 49.5%, peptic stricture in 30.4%, post sclerotherapy stricture in 12.1%, corrosive injury in 4%, post-operative stricture in 4%. In comparative analysis of achalasia and inflammatory groups, good response to dysphagia was seen in 40/49 (82%) and 22/50 (44%) respectively p < 0.001. Weight gain was 35/49 (72%) and 22/50 (44%) p <0.001 respectively. Significantly, more endoscopic sessions were required in inflammatory group compare to achalasia; 2.2 and 1.1 respectively; p <0.001 and 160% complications rate in inflammatory group comparing to no complications in achalasia.CONCLUSIONS: Dysphagia and weight loss were common presentations in non-malignant esophageal diseases. Therapeutic intervention in inflammatory group was associated with high complication than the achalasia group.