Dilation of esophageal strictures with dilators passed over a guidestring or guidewire is of proven usefulness. Techniques for the placement of such a guidewire include that originally described by Sippy in 1913, which depends on peristalsis for the passage of a string. Passage of a flexible wire with the aid of fluoroscopy or a conventional esophagoscope improved the original technique. The major disadvantage with these techniques is that the tip of the wire cannot be controlled for passage through the immediate area of the cicatricial narrowing. In difficult cases with marked narrowing, perforation is a likely complication.
The most recent fiberoptic gastroscopes can be very accurately controlled while in the lumen of the esophagus. It has been determined that the guidewire from a Peustow esophageal dilation set passes readily through the biopsyaspiration channel of a fiberoptic gastroscope (Figure). This permits passage of the guidewire through a stricture very precisely and
Marco JD, Keltner RM. Placement of Guidewire for Esophageal DilationImproved Technique. Arch Surg. 1975;110(10):1251. doi:10.1001/archsurg.1975.01360160089017
* * SCHEDULED MAINTENANCE * *
The JAMA Network Sites will be conducting routine maintenance from 10/20/2017 through 10/21/2017. During this window access to content and authentication may be intermittently available. The JAMA Store will be completely unavailable during the maintenance window.