Klimashevich A.V. 1
Nikolskiy V.I. 1
Nazarov V.A. 1
Bogonina O.V. 1
Shabrov A.V. 1
1 Penza State University
«Gold standard» of conservative treatment of esophageal post-burn cicatricial strictures is in various versions. We have developed a tactic of conservative treatment of post-burn scar stricture. We use the orthograde bougienage on thread and string guide (236 patients) as a safe method of bougienage. Patient previously had ingested nylon thread, which took place for the stricture and was fi xed in the gastro-intestinal tract. Metal conductor was put on the thread. Orthograde bougienage was implemented by the conductor with elastic bougies with sloped channel for the conductor. When it was impossible to get a conductor for the strictures with sub-and decompensated cicatricial strictures, it was used retrograde bougienage with gastrostomy in the modifi cation of A.F. Chernousov (19 patients). It could to get a conductor for the strictures in all patients with decompensated disease and perform orthograde bougienage (6 patients) with the advention in recent years of hydrophilic conductors with different tips. Good and satisfactory results were obtained in the treatment of all patients – patency of the esophagus was restored. There were the following complications: bleeding – 3 (1,2 %), perforation of the esophagus 2 (0,8 %), perforation of the stomach 1 (0,4 %). The main problem of bougienage is frequent episodes of restenosis occurred in 48 (18 %) patients, which required additional methods of treatment: stenting and perform reconstructive operations on the esophagus.