Özet:

The oldest known method for treating ozofagus tiredness is the pushing process made with a whale cheek that is similar to today’s dilatators. The first written record is that the Italian anatomist Fabricius ab Aquapendente, who lived in Bejaia, an Algeria city in the 17th century, used the balm as a rijid dilatator. The bujing method for the dilatation of the ozophagus stricts was first published in 1821. The normal ozofagus lumen diameter is between 20-30 mm, and disphagia begins to appear when it is thinner than 12 mm. It must be at least 15 mm for symptomatic healing. The cause of depression is often considered peptic ozofaith (70-80%), anastomosis depression, trauma, radiation therapy, corrosive burns. Physical examination often does not provide a clue about the cause of disfusion. It is important to determine the patient's nutritional status. For the diagnostic purposes, the baryum ozofagus passage graph should be completed with endoscopic findings; first the treatment of the aggressive proton pump inhibitors (PIP) according to the degree of density in the treatment ranking, then the bulk or ballon dilatation, the corticosteroid injection in treatment resistant cases, and, if it continues, the stent placement processes that can be extended can be performed. Stentler should never be used as the first stage of treatment and should be left after multiple dilatation sessions to be applied. While simple stretches respond well to an aggressive PIP treatment or 2-3 sessions of buji dilatation, the complex ones are made PEG especially in cases where the proximal guide thread does not advance and are intervened strictly as retrograde. Dilatation complications: there is a risk of 0.1-0.3 per cent of perfotation and less than 0.2 per cent of bleeding. Covered or uncovered metal stents or non-metallic stents are used that extend themselves in severe shrinkings. Although applied to carefully selected patients, stent migration, severe chest pain, bleeding, perforation, gastro-osophageal reflux, stent blocks and fistulary complications have been observed. Alternative treatment procedures in severe contractions are applied for endoscopic stricturoplasty and ultimately for surgical resection. Many studies have shown that progressive application of dilatation up to 40-60F diameter for peptic narrowness relieves dysphia in 85% of patients with a low rate of complications. Nevertheless, about 30% of patients needed repeat dilatation within 1 year, and 60% of those who do not have an anti-secretary drug support. The success of the surgical application varies depending on the surgeon’s experience and the patient’s capacity to exhaust the ozofagus of the center, which is usually around 77%. The need for dilatation after surgery occurs in 1-43 percent of patients and usually 1-2 sessions are required. (JAREM 2016; 6: 1-14)

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