EFFICACY OF ENDOSCOPIC BALLOON DILATION IN IRANIAN PEDIATRIC PATIENTS WITH ESOPHAGEAL STRICTURE

ABSTRACT BACKGROUND: Esophageal stenosis (ES) in children is a fixed intrinsic narrowing of the esophagus due to numerous aetiologies. OBJECTIVE: This study aimed to determine the clinical and nutritional impacts of endoscopic balloon dilation (EBD) in Iranian children with an esophageal stricture. METHODS: This retrospective study, pediatric patients (aged <18 years) who underwent EBD for esophageal stricture from April 2015 until March 2020 in Abuzar Children’s Hospital (Ahvaz, Iran) were enrolled in the study. Outcome parameters were the frequency of dilations, nutritional status, complications, and clinical success rates. EBD was used in children with radiologic evidence of esophageal stenosis. The nutritional status was evaluated by weight-for-age (z-score). Clinical success was considered as no necessity of EBD for a minimum of one year and/or increasing interval among dilation and the frequency of EBD was less than four times per year. RESULTS: A total of 53 cases (mean age, 4.72±3.38 years) were enrolled. There were 25 (47.2%) females and 28 (52.8%) males. During follow-up, a total of 331 EBD sessions were performed, with an average of 6.24 sessions per patient. There was one case of perforation and one case of mediastinitis, while there was no other complication or mortality. The clinical success rate of EBD therapy was 62.3% (33/53). The mean standard deviation z-score weight-for-age of patients before and after endoscopic dilation was 2.78 (2.41) and 1.18 (1.87), respectively. The t-test showed a significant difference between the weights-for-age (z-score) before and after endoscopic dilation. The majority of the patients had raised weight-for-age (z-score) after EBD treatment. CONCLUSION: EBD attained a good clinical success rate and nutritional improvement in children with an esophageal stricture.

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The Efficacy and Safety of Balloon Enteroscopy-Assisted Endoscopic Retrograde Cholangiography in Pediatric Patients with Surgically Altered Gastrointestinal Anatomy

Journal of Clinical Medicine ◽

10.3390/jcm10173936 ◽

2021 ◽

Vol 10 (17) ◽

pp. 3936

Author(s):

Kensuke Yokoyama ◽

Tomonori Yano ◽

Atsushi Kanno ◽

Eriko Ikeda ◽

Kozue Ando ◽

...

Keyword(s):

Success Rate ◽

Pediatric Patients ◽

Clinical Success ◽

Clinical Success Rate ◽

Endoscopic Retrograde Cholangiography ◽

Adult Patients ◽

Efficacy And Safety ◽

Duodenal Papilla ◽

Endoscopic Retrograde ◽

Balloon Enteroscopy

Balloon enteroscopy-assisted endoscopic retrograde cholangiography (BEA-ERC) is useful and feasible in adults with pancreatobiliary diseases, but its efficacy and safety have not been established in pediatric patients. We compared the success rate and safety of BEA-ERC between adults and pediatric patients. This single-center retrospective study reviewed 348 patients (pediatric: 57, adult: 291) with surgically altered gastrointestinal anatomies who underwent BEA-ERC for biliary disorders from January 2007 to December 2019. The success rate of reaching the anastomosis or duodenal papilla was significantly lower in pediatric patients than in adult patients (66.7% vs. 88.0%, p < 0.01). The clinical success rate was also significantly lower in pediatric patients (64.9% vs. 80.4%, p = 0.014). The rate of adverse events was significantly higher in pediatric patients than in adults (14.2% vs. 7.7%, p = 0.037). However, if the anastomotic sites were reached in pediatric patients, the treatment was highly successful (97.3%). The time of reaching target site was significantly longer in pediatric patients than in adult patients. This study shows that BEA-ERC in pediatric patients is more difficult than that in adult patients. However, in patients where the balloon enteroscope was advanced to the anastomosis, clinical outcomes comparable to those in adults can be achieved.

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M1411: Endoscopic Balloon Dilation and Radial Incision and Cutting Are Safe and Useful for Treatment of Benign Esophageal Stricture After Endoscopic Submucosal Dissection for Superficial Esophageal Cancers

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2010.03.411 ◽

2010 ◽

Vol 71 (5) ◽

pp. AB214

Author(s):

Hiroaki Minamino ◽

Hirohisa Machida ◽

Kazunari Tominaga ◽

Masami Nakatani ◽

Yasuaki Nagami ◽

...

Keyword(s):

Endoscopic Submucosal Dissection ◽

Esophageal Stricture ◽

Balloon Dilation ◽

Endoscopic Balloon Dilation ◽

Benign Esophageal Stricture ◽

Esophageal Cancers ◽

Submucosal Dissection ◽

Radial Incision ◽

Endoscopic Balloon

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Sa2077 Usefulness of Endoscopic Balloon Dilation for Esophageal Stenosis in Children

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2016.03.502 ◽

2016 ◽

Vol 83 (5) ◽

pp. AB308 ◽

Cited By ~ 1

Author(s):

Tatsuya Osuga ◽

Saori Kakuyama ◽

Eishin Nakajima ◽

Chikara Kadota ◽

Kazunori Hasegawa ◽

...

Keyword(s):

Balloon Dilation ◽

Esophageal Stenosis ◽

Endoscopic Balloon Dilation ◽

Endoscopic Balloon

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Stent Flange-Induced Esophageal Stricture Treated with an Oral Steroid

Korean Journal of Medicine ◽

10.3904/kjm.2021.96.4.352 ◽

2021 ◽

Vol 96 (4) ◽

pp. 352-355

Author(s):

Junyoung Seo ◽

Ju Sang Park

Keyword(s):

Esophageal Stricture ◽

Anastomotic Stricture ◽

Balloon Dilation ◽

Oral Steroid ◽

Metallic Stent ◽

Endoscopic Balloon Dilation ◽

Stent Removal ◽

First Case ◽

Covered Metallic Stent ◽

Endoscopic Balloon

Esophageal stent complications include stent migration, tumor ingrowth, perforation, a broncho-esophageal fistula, and gastroesophageal reflux. Development of a new stricture at a flange site after stent removal has been predicted but not yet reported. We experienced the first case of a recurrent esophageal stricture induced by a stent flange after stent removal. A fully covered metallic stent, which had been inserted 2 months ago for treatment of an anastomotic stricture, triggered another stricture at the flange site. Although endoscopic balloon dilatations were repeated several times and then the 2nd stent for rescue therapy was inserted, the stricture was refractory to all treatment. Thus, we prescribed oral prednisolone with repeated endoscopic balloon dilation; the stricture eventually improved. The oral steroid seemed to suppress stricture development. If a stent flange-induced refractory stricture is encountered, an oral steroid combined with endoscopic balloon dilation may be helpful.

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Roles of Steroids in Preventing Esophageal Stricture after Endoscopic Resection

Canadian Journal of Gastroenterology and Hepatology ◽

10.1155/2019/5380815 ◽

2019 ◽

Vol 2019 ◽

pp. 1-9 ◽

Cited By ~ 1

Author(s):

Yu Qiu ◽

Ruihua Shi

Keyword(s):

Endoscopic Resection ◽

Esophageal Stricture ◽

Steroid Injection ◽

Relevant Literature ◽

Balloon Dilation ◽

Oral Steroid ◽

Stricture Formation ◽

Steroid Administration ◽

Local Steroid Injection ◽

Endoscopic Balloon

Background and Purposes. Endoscopic resection has been worldwide recognized as a treatment strategy for early esophageal lesions. The occurrence of esophageal stricture after endoscopic resection will reduce the quality of life of patients. This study will evaluate the efficacy and safety of steroids in the prevention of esophageal stricture after endoscopic resection and the influence of different steroid administration methods.Methods. In the relevant literature database, literature from 2008 to 2018 is retrieved by using preset keywords, the search results are carefully screened, and the conclusion of the literature is synthesized to form arguments and draw conclusions.Results. 73 articles met our requirements. Oral steroid administration, not prophylactic endoscopic balloon dilation alone, was effective in preventing esophagostenosis after esophagoscopic treatment and reducing the number of repeated endoscopic balloon dilations even after extensive endoscopic resection. Local steroid injection is useful and economy for preventing esophageal stricture, even though it may raise the risk of perforation during dilations. A wider range of circumferential mucosal defects is an independent predictor for stricture formation for patents given preventive steroid injections after endoscopic submucosal dissection. For complete circular mucosal defect, the further researches are essential to investigate the role of local steroid injection. The effect of other methods such as steroid gel, intravenous infusion of steroid, and novel steroid filling methods require more confirmation.Conclusions. Therefore, steroids play an irreplaceable role in preventing esophageal stricture after endoscopic resection. Oral and local injections of steroids are the two most acceptable methods and more prospective studies are needed to compare the effectiveness and safety of these two methods.

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