Technical feasibility, clinical effectiveness, and safety of esophageal stricture dilation using a novel endoscopic attachment cap in adults with eosinophilic esophagitis - 13/10/21

Doi : 10.1016/j.gie.2021.05.017

Alain M. Schoepfer, MD ^1,^⁎^{^{∗
Drs Schoepfer and Henchoz and Safroneeva and Godat contributed equally to this article.}}, Sarah Henchoz, MD ^1,^{^{∗
Drs Schoepfer and Henchoz and Safroneeva and Godat contributed equally to this article.}}, Luc Biedermann, MD ², Philipp Schreiner, MD ², Thomas Greuter, MD ^1,², Antoine Reinhard, MD ³, Jonduri Senn, MD ⁴, Annett Franke, MD ⁵, Emanuel Burri, MD ⁶, Pascal Juillerat, MD, MPH ⁷, Hans-Uwe Simon, MD, PhD ^8,⁹, Alex Straumann, MD ², Ekaterina Safroneeva, PhD ^10,^{^{∗
Drs Schoepfer and Henchoz and Safroneeva and Godat contributed equally to this article.}}, Sébastien Godat, MD ^1,^{^{∗
Drs Schoepfer and Henchoz and Safroneeva and Godat contributed equally to this article.}}
¹ Division of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne, Lausanne, Switzerland
² Division of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland
³ Division of Otorhinolaryngology, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne, Lausanne, Switzerland
⁴ Division of Gastroenterology and Hepatology, Kantonsspital Lucerne, Lucerne, Switzerland
⁵ Division of Gastroenterology and Hepatology, Kantonsspital St Gallen, Switzerland
⁶ Gastroenterology and Hepatology, University Medical Clinic, Kantonsspital Baselland, Liestal, Switzerland
⁷ Division of Gastroenterology and Hepatology, Inselspital Bern, University of Bern, Bern, Switzerland
⁸ Institute of Pharmacology, University of Bern, Bern, Switzerland
⁹ Department of Clinical Immunology and Allergology, Sechenov University, Moscow, Russia
¹⁰ Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland

^∗Reprint requests: Alain Schoepfer, MD, Division of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois (CHUV), Rue du Bugnon 44/07/2425, CH-1011, Lausanne, Switzerland.Division of Gastroenterology and HepatologyCentre Hospitalier Universitaire Vaudois (CHUV)Rue du Bugnon 44/07/2425LausanneCH-1011Switzerland

Abstract

Background and Aims

The BougieCap (Ovesco Endoscopy AG, Tübingen, Germany) is a new device that allows optical and tactile feedback during stricture dilation of the upper GI tract. We evaluated the technical feasibility, clinical efficacy, and safety of a 1-time esophageal stricture dilation using the BougieCap in adults with eosinophilic esophagitis (EoE).

Methods

EoE patients prospectively included in the Swiss EoE Cohort were dilated with the BougieCap for 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 instrument (score ranges from 0 to 100 points).

Results

Fifty patients (70% men; median age, 41 years; median disease duration, 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 antieosinophil therapy) were evaluated. Endoscopic bougienage was technically successful in 100%. The median esophageal diameter increased from 12 mm (interquartile range [IQR], 12-13) to 16 mm (IQR, 16-16; P < .001). Median symptom severity dropped from 32 points (IQR, 27-41) to 0 (IQR, 0-10; P < .001) at 2 weeks postdilation. In 1 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 the BougieCap is technically feasible and safe and offers significant symptomatic improvement in the short term.

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Graphical abstract

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Abbreviations : EoE, EEsAI PRO, SEECS

Plan

Baseline characteristics

Technical feasibility, clinical efficacy, and safety of esophageal stricture dilation using the BougieCap

Logistic aspects

Discussion

	DISCLOSURE: The following authors received research support for this study from the Swiss National Science Foundation: A. M. Schoepfer (grant 32003B_160115/1), E. Safroneeva (185008). All other authors disclosed no financial relationships. Research support for this study (A. Schoepfer) was provided by the Swiss EoE foundation and grants from Sanofi-Genzyme, Astra-Zeneca, and Dr Falk Pharma.
	If you would like to chat with an author of this article, you may contact Dr Schoepfer at alain.schoepfer@chuv.ch.
	See CME section, p. 998.

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Vol 94 - N° 5

P. 912 - novembre 2021 Retour au numéro

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Technical feasibility, clinical effectiveness, and safety of esophageal stricture dilation using a novel endoscopic attachment cap in adults with eosinophilic esophagitis - 13/10/21

Abstract

Background and Aims

Methods

Results

Conclusions

Graphical abstract

Plan

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